Active NPI
Janet Jackson Fredrick
- Clinical Social Worker
- Columbia, SC
National Provider Identifier
1609509439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW.14846
- Practice address
- 1140 Briargate Cir
Columbia, SC 29210-6504 - Phone
- (205) 478-9579
- NPI assigned
- Jul 8, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW.14846 | SC | Primary |
Addresses
Primary practice location
1140 Briargate Cir
Columbia, SC 29210-6504
Mailing address
1140 Briarsgate Circle
Columbia, SC 29210
Other practice location 1
1140 Briargate Cir
Columbia, SC 29210-6504
Phone (205) 478-9579
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW.14846 | SC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657238400000",
"number": "1609509439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1140 BRIARSGATE CIRCLE",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1140 BRIARGATE CIR",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292106504",
"telephone_number": "205-478-9579"
}
],
"practiceLocations": [
{
"address_1": "1140 Briargate Cir",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "SC",
"postal_code": "292106504",
"country_code": "US",
"telephone_number": "205-478-9579",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FREDRICK",
"first_name": "JANET",
"middle_name": "JACKSON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-08",
"last_updated": "2022-07-08",
"certification_date": "2022-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "SC",
"license": "SW.14846",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.