Active NPI
Alicia Fredericksen, LPC
- Mental Health Counselor
- Falls Church, VA
National Provider Identifier
1811568702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0701008836
- Practice address
- 3300 Gallows Rd
Falls Church, VA 22042-3307 - Phone
- (703) 776-6563
- NPI assigned
- Jul 2, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 0701008836 | VA | Primary |
Addresses
Primary practice location
3300 Gallows Rd
Falls Church, VA 22042-3307
Mailing address
3300 Gallows Road
Kristen Ceranic
Falls Church, VA 22042
Phone (703) 776-7765
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625184000000",
"number": "1811568702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 GALLOWS ROAD",
"address_2": "KRISTEN CERANIC",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "22042",
"telephone_number": "703-776-7765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 GALLOWS RD",
"city": "FALLS CHURCH",
"state": "VA",
"postal_code": "220423307",
"telephone_number": "703-776-6563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICKSEN",
"first_name": "ALICIA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-02",
"last_updated": "2021-07-02",
"certification_date": "2021-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": "0701008836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Falls Church, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.