Heather Eileen Frederick

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

007551 Issued in NY

Practice address

31 Thurber Dr
Waterloo, NY 13165-1649

Phone

(315) 539-1980

NPI assigned

Sep 13, 2013

Last updated

Oct 28, 2016By the provider in NPPES

Sex

Female

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": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1366877920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 CAYUGA ST",
            "city": "SENECA FALLS",
            "state": "NY",
            "postal_code": "131481117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 THURBER DR",
            "city": "WATERLOO",
            "state": "NY",
            "postal_code": "131651649",
            "telephone_number": "315-539-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "HEATHER",
        "middle_name": "EILEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-13",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "007551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Waterloo, NY
• Providers in Waterloo, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; 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.