Leerisa Frederick

Primary specialty

CounselorTaxonomy code 101Y00000X

License

10584 Issued in NU

Practice address

416 S Mustang Rd Ste B
Yukon, OK 73099-7314

Phone

(405) 494-0644

NPI assigned

Mar 19, 2019

Last updated

Dec 8, 2023By 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

Practice roles

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

• Integrated Therapy Solutions of Oklahoma, LLC

  • Community/Behavioral Health Agency
  • Moore, OK
  • NPI 1659855278
  NPD (past)

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1467911412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 S MUSTANG RD STE B",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730997314",
            "telephone_number": "405-448-6163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 S MUSTANG RD STE B",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730997314",
            "telephone_number": "405-494-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "LEERISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": "10584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brionna Foster, LPC-C
• Brittney Foster
• Tracye Fowler, FNP
• Bryan Lee Frank, M.D.
• Amanda Franson
• Tara Freeman, CRNA
• Fresenius Medical Care Yukon, LLC (Fresenius Medical Care Yukon)
• Athena J Friese, M.D.
• Makenzie Friesen
• John Fullington, DDS

• Counselor in Yukon, OK
• Providers in Yukon, OK by specialty
• Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.