Individual provider Active NPI

Joanna Frederick, LCSW

  • Clinical Social Worker
  • Media, PA
National Provider Identifier
1336477504
Registry record updated Jan 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW016495 Issued in PA
Practice address
1055 E Baltimore Pike
Suite 306
Media, PA 19063-5173
Phone
(610) 892-3800
NPI assigned
Nov 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW016495 PA Primary

Addresses

Primary practice location

1055 E Baltimore Pike
Suite 306
Media, PA 19063-5173

Mailing address

1055 E Baltimore Pike
Suite 306
Media, PA 19063-5173
Phone (610) 892-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294444800000",
    "number": "1336477504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 E BALTIMORE PIKE",
            "address_2": "SUITE 306",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635173",
            "telephone_number": "610-892-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 E BALTIMORE PIKE",
            "address_2": "SUITE 306",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635173",
            "telephone_number": "610-892-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "JOANNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-30",
        "last_updated": "2011-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.