Active NPI
Rita Frederick, LCMHC
- Mental Health Counselor
- Shelburne, VT
National Provider Identifier
1699987461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0680000567
- Practice address
- 178 Kelady Dr
Shelburne, VT 05482-6450 - Phone
- (802) 985-4961
- NPI assigned
- May 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0680000567 | VT | Primary |
Addresses
Primary practice location
178 Kelady Dr
Shelburne, VT 05482-6450
Mailing address
178 Kelady Dr
Shelburne, VT 05482-6450
Phone (802) 985-4961
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 59987 | Other | VT | BCBS PROVIDER NUMBER |
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 |
|---|---|---|---|
| 0680000567 | VT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699987461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "178 KELADY DR",
"city": "SHELBURNE",
"state": "VT",
"postal_code": "054826450",
"telephone_number": "802-985-4961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "178 KELADY DR",
"city": "SHELBURNE",
"state": "VT",
"postal_code": "054826450",
"telephone_number": "802-985-4961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICK",
"first_name": "RITA",
"credential": "LCMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VT",
"license": "0680000567",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "59987",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Shelburne, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.