Individual provider Active NPI

Willard J. Frederick, LCSW

  • Clinical Social Worker
  • Muncie, IN
National Provider Identifier
1659323954
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34001033A Issued in IN
Practice address
240 N Tillotson Ave
Muncie, IN 47304-3988
Phone
(765) 288-1928
Fax
(765) 741-0340
NPI assigned
May 16, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34001033A IN Primary

Addresses

Primary practice location

240 N Tillotson Ave
Muncie, IN 47304-3988

Mailing address

3645 N Briarwood LN
Ste a
Muncie, IN 47304-5337
Phone (765) 289-5520

Other names 1

  • Bill J. Frederick Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20050526000600 IN Practitioner - Clinical Social Worker 2365484672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tyrow Consulting LLCGroup PAC ID 6608196787, 16 clinicians

Practice addresses (Care Compare)

3645 N Briarwood LN
Suite a
Muncie, IN 47304-5337
Phone (765) 289-5520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34001033AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tyrow Consulting LLC CurrentSince Mar 10, 2020 Accepting new patients

Locations

3645 N Briarwood Ln
Ste A
Muncie, IN 47304
Phone (765) 289-5520

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1659323954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 N BRIARWOOD LN",
            "address_2": "STE A",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473045337",
            "telephone_number": "765-289-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "WILLARD",
        "middle_name": "J.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2026-07-13",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34001033A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BILL",
            "last_name": "FREDERICK",
            "middle_name": "J.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

Verify at the official NPI Registry.