Individual provider Active NPI

Julie Frederick, LCPC

  • Mental Health Counselor
  • Kalispell, MT
National Provider Identifier
1346791241
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
BBH-LCPC-LIC-19128 Issued in MT
Practice address
1372 Airport Rd
Kalispell, MT 59901-5701
Phone
(406) 407-0815
NPI assigned
Oct 17, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X BBH-LCPC-LIC-19128 MT Primary

Addresses

Primary practice location

1372 Airport Rd
Kalispell, MT 59901-5701

Mailing address

1372 Airport Rd
Kalispell, MT 59901-5701
Phone (406) 407-0815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251112003521 MT Practitioner - Mental Health Counselor 9638660145 Practice locations: Kalispell, MT

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1372 Airport Rd
Kalispell, MT 59901-5701
Phone (406) 407-0815

21001 N Tatum Blvd
Suite 190
Phoenix, AZ 85050-4206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BBH-LCPC-LIC-19128MTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rojo Ventures, Inc. PastSince Oct 29, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1346791241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1372 AIRPORT RD",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599015701",
            "telephone_number": "406-407-0815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1372 AIRPORT RD",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599015701",
            "telephone_number": "406-407-0815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "JULIE",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MT",
            "license": "BBH-LCPC-LIC-19128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.