Kathleen Fredericks, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC007510 Issued in PA

Practice address

315 Hillside Ave
Jenkintown, PA 19046-2008

Phone

(267) 343-9015

NPI assigned

Jul 27, 2016

Last updated

Apr 19, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1497208326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 HILLSIDE AVE",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190462008",
            "telephone_number": "267-343-9015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 HILLSIDE AVE",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190462008",
            "telephone_number": "267-343-9015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-27",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC007510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fox Chase Medical Center
• Robert Douglas Fox, M.D.
• Cheryl Nikki Foxworth, MA, LMFT, AS
• Maureen A Foy-Tornay, LPC
• Peter B. Frechie, D.O.
• Jordyn Freed, CCC-SLP
• Lena Freed, LCMHC, LPC
• Dana Freidly, LPC
• Martha Jane Fried-Cassorla, PHD
• Emily Froggatt, CRNP

• Professional Counselor in Jenkintown, PA
• Providers in Jenkintown, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.