Kristine Lee Fredericksdorf

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SL06327200 Issued in NJ

Practice address

1930 Route 70 E Ste R91
Cherry Hill, NJ 08003-4207

Phone

(856) 751-0505

Fax

(888) 399-1804

NPI assigned

Mar 2, 2018

Last updated

Mar 2, 2018By 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

Opted out of Medicare

Yes, effective Jun 4, 2024 through Jun 4, 2028

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.

• Meridian Counseling Services, LLC

  • Clinical Social Worker
  • Cherry Hill, NJ
  • NPI 1962550210
  NPD (past)

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

{
    "created_epoch": "1519948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519948800000",
    "number": "1679075865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 CIDER PRESS DR",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080629481",
            "telephone_number": "856-478-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 ROUTE 70 E STE R91",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080034207",
            "telephone_number": "856-751-0505",
            "fax_number": "888-399-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKSDORF",
        "first_name": "KRISTINE",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-02",
        "last_updated": "2018-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06327200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Franzwa
• Ashley Frazell
• Jennifer A Frazer, OT
• Tara Frederick
• Alison Fredericks, BCBA
• Bionca Freeman
• Kira M French, PT
• Carlita Freni, LPC
• Rachael C Freni, LCSW
• Carla M Fried, MSPT

• Social Worker in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.