Active NPI
Ericka Tiphany Frederick, SCL, LLC
- Counselor
- Southfield, MI
National Provider Identifier
1871376764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6451023222
- Practice address
- 29425 Northwestern Hwy Ste 215
Southfield, MI 48034-1000 - Phone
- (248) 327-7409
- NPI assigned
- Aug 15, 2023
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6451023222 | MI | Primary |
Addresses
Primary practice location
29425 Northwestern Hwy Ste 215
Southfield, MI 48034-1000
Mailing address
31278 Schoenherr Rd Apt 5
Warren, MI 48088-1943
Phone (313) 658-5133
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 |
|---|---|---|---|
| 6451023222 | MI | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Counseling Works, PLLC | Past | Accepting new patients |
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.
-
- Professional Counselor
- Detroit, MI
- NPI 1225547136
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692057600000",
"number": "1871376764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31278 SCHOENHERR RD APT 5",
"city": "WARREN",
"state": "MI",
"postal_code": "480881943",
"telephone_number": "313-658-5133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29425 NORTHWESTERN HWY STE 215",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480341000",
"telephone_number": "248-327-7409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICK",
"first_name": "ERICKA",
"middle_name": "TIPHANY",
"credential": "SCL, LLC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-15",
"last_updated": "2023-08-15",
"certification_date": "2023-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6451023222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.