Robert Fredrickson III, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

25931 484TH Ave
Valley Springs, SD 57068-6602

Phone

(605) 212-3772

NPI assigned

Mar 19, 2022

Last updated

Mar 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1647648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647648000000",
    "number": "1346999208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25931 484TH AVE",
            "city": "VALLEY SPRINGS",
            "state": "SD",
            "postal_code": "570686602",
            "telephone_number": "605-212-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25931 484TH AVE",
            "city": "VALLEY SPRINGS",
            "state": "SD",
            "postal_code": "570686602",
            "telephone_number": "605-212-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKSON",
        "first_name": "ROBERT",
        "name_suffix": "III",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-19",
        "last_updated": "2022-03-19",
        "certification_date": "2022-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candy Kay Bruce
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• Debra McClintock, MSW LCSW -PIP QMHP
• Alyssa Shay Pfeifle, P.T
• Lorella L Pritt, LPN

• Professional Counselor in Valley Springs, SD
• Providers in Valley Springs, SD by specialty
• Professional Counselor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2022; 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.