Brooklynn J Fredericksen, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22680 Issued in MN

Practice address

2575 Harvest LN
Owatonna, MN 55060-4305

Phone

(507) 446-0431

Fax

(507) 446-8014

NPI assigned

Apr 28, 2016

Last updated

Apr 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)

Enrolled

State licenses

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.

• Fernbrook Family Center

  • Social Worker
  • Red Wing, MN
  • NPI 1437427911
  NPD (past)

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1508211467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 977",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550600977",
            "telephone_number": "507-446-0431",
            "fax_number": "507-446-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 HARVEST LN",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550604305",
            "telephone_number": "507-446-0431",
            "fax_number": "507-446-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKSEN",
        "first_name": "BROOKLYNN",
        "middle_name": "J",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Foster, MA
• Fourth Trimester Physical Therapy LLC
• Audrey Elizabeth Franklin, MSW
• Mary Kathleen Fransen, M.S.W.
• Heather A Frederick, LICSW
• Joshua Lee Prince Freitag
• Kent Walter Frette, DDS PA
• Kiley Friedrichs
• Full Circle Counseling and Wellness, PC
• Sarah Catherine Gantert, MD

• Clinical Social Worker in Owatonna, MN
• Providers in Owatonna, MN by specialty
• Clinical Social Worker in Minnesota

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