Individual provider Active NPI

Louis Frederick

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1790374460
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
5615 W Pico Blvd
Los Angeles, CA 90019-3835
Phone
(323) 937-1344
NPI assigned
Jan 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

5615 W Pico Blvd
Los Angeles, CA 90019-3835

Mailing address

1303 Hepner Ave
Los Angeles, CA 90041-2436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 20, 2025 through Nov 20, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Counseling Center CurrentSince Mar 5, 2023 Accepting new patients

Locations

5615 W Pico Blvd
Los Angeles, CA 90019
Phone (323) 487-9003

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1790374460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 HEPNER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900412436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900193835",
            "telephone_number": "323-937-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "LOUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-15",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.