Stephanie Fredrick, PHD, LLP

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

6301016859 Issued in MI

Practice address

1101 Health Professions BLDG
Mt Pleasant, MI 48859-0001

Phone

(989) 774-3904

Fax

(989) 774-1891

NPI assigned

Sep 12, 2016

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

Other identifiers 1

Other names 1

• Stephanie M Secord Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1699223214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 HEALTH PROFESSIONS BLDG",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488590001",
            "telephone_number": "989-774-3904",
            "fax_number": "989-774-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 HEALTH PROFESSIONS BLDG",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488590001",
            "telephone_number": "989-774-3904",
            "fax_number": "989-774-1891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICK",
        "first_name": "STEPHANIE",
        "credential": "PHD, LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MI",
            "license": "6301016859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "6301016859",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SECORD",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Arianna Frank
• Shelley L Frantz, PA
• Corissa Lynn Frasier
• Frederick Bonds DDS PC
• Cathy Louise Frederick, CPSS
• Shelby Fredricks, DNP, CPNP-PC
• Abigail Freed
• Breanna Renae Friend
• Katherine Fulco, RPH
• Donna J Fuller, M.A., L.L.P.

• School Psychologist in Mt Pleasant, MI
• Providers in Mt Pleasant, MI by specialty
• School Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.