Ashley Fredericks

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1336797224 Issued in CO

Practice address

1735 30TH Ave N Unit 1/2
St Petersburg, FL 33713-4156

Phone

(970) 365-3802

NPI assigned

Sep 3, 2019

Last updated

Dec 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1336797224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4795 SIGNAL ROCK RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809221625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 30TH AVE N UNIT 1/2",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337134156",
            "telephone_number": "970-365-3802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4905 N Union Blvd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809184063",
            "country_code": "US",
            "telephone_number": "970-364-3802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "ASHLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "1336797224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Nichole Fream, OTR/L
• Amanda Frechette
• Freddie L McRae MD PA
• Frederick T Feaster MD Inc
• Leah Sue Frederick, LCSW
• Irina Fredericks, PH.D., LMHC
• Lawrence Robert Free, D.C.
• Charles R Freeble III, MD
• Carlee Freed, PA
• Frederick Scott Freed, D.C.

• Mental Health Counselor in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.