Erling L Fredrickson, LISW-CP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C006294 Issued in NC

Practice address

158 Grandfather Home Way, Hickory Nut Gap Rd.
Banner Elk, NC 28604

Phone

(828) 898-6140

Fax

(828) 898-8513

NPI assigned

Apr 24, 2007

Last updated

Nov 16, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258329600000",
    "number": "1730308172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98",
            "city": "BANNER ELK",
            "state": "NC",
            "postal_code": "286040098",
            "telephone_number": "828-898-6140",
            "fax_number": "828-898-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 GRANDFATHER HOME WAY, HICKORY NUT GAP RD.",
            "city": "BANNER ELK",
            "state": "NC",
            "postal_code": "28604",
            "telephone_number": "828-898-6140",
            "fax_number": "828-898-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKSON",
        "first_name": "ERLING",
        "middle_name": "L",
        "credential": "LISW-CP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2009-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "5710",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfred Douglas Earwood, MD
• Michelle Leigh Eggers
• Katherine Kragiel Elder, LCSW
• Elizabeth B. Hill, M.D., PLLC
• Elk River Medical Associates, PA
• Grandfather Home for Children (Children's Hope Alliance)
• Christine Marie Halterman
• Cindy Allison Herold, MA CCCSLP
• Elizabeth Beu Hill, M.D.
• His High Places, Inc

• Clinical Social Worker in Banner Elk, NC
• Providers in Banner Elk, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; 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.