Carrie Fredricksen LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

CARRIE FREDRICKSEN LLC

Practice address

830 S 5TH St Ste If
Cottonwood, AZ 86326-4325

Phone

(928) 300-5070

NPI assigned

Oct 3, 2024

Organization subpart

No

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

Authorized official

Name

Carrie Fredrickesen, LPC

Title

Owner

Phone

(928) 300-5070

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1727913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1407675853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2226 W NEWTON LN",
            "city": "CAMP VERDE",
            "state": "AZ",
            "postal_code": "863224939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S 5TH ST STE IF",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264325",
            "telephone_number": "928-300-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARRIE FREDRICKSEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-03",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "FREDRICKESEN",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-300-5070",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Cottonwood, AZ
• Providers in Cottonwood, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.