Frederick Smith, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071010014 Issued in IL

Practice address

7425 Janes Ave Ste 205
Woodridge, IL 60517-2323

Phone

(331) 481-5547

NPI assigned

Sep 27, 2017

Last updated

Jan 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thriveworks Clinical - IllinoisGroup PAC ID 6800263823, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.fredericksmith@146897.advancedmd-direct.com

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.

• Thriveworks Clinical - Illinois

  dba Thriveworks

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1164190633
  Medicare reassignment Care Compare group NPD
• Edgewood Clinical Services, P.C.

  dba LifeStance

  • Psychologist
  • Naperville, IL
  • NPI 1295914646
  Medicare reassignment NPD
• Edgewood Clinical Services, P.C.

  dba LifeStance

  • Community/Behavioral Health Agency
  • Naperville, IL
  • NPI 1366784837
  NPD (past)
• Psychology Specialists LTD

  dba LifeStance Health

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)

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

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1568971091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7425 JANES AVE STE 205",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605172323",
            "telephone_number": "331-481-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7425 JANES AVE STE 205",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605172323",
            "telephone_number": "331-481-5547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7900 Cass Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Darien",
            "state": "IL",
            "postal_code": "605615073",
            "country_code": "US",
            "telephone_number": "888-428-7890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1051 Essington Rd Ste 280",
            "address_purpose": "LOCATION",
            "city": "Joliet",
            "state": "IL",
            "postal_code": "604352808",
            "country_code": "US",
            "telephone_number": "779-243-5677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-27",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY004131",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071010014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Slavick
• Sleep Matters, LTD.
• Smart Mouth Dental P.C.
• Brittany M Smith
• David C Smith, D.C.
• Bridget Snyder, MA
• Elizabeth A Solans, DMD
• Soleo Health Inc
• Soleo Health Inc.
• Soleo Health Inc.

• Clinical Psychologist in Woodridge, IL
• Providers in Woodridge, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.