Kristin Jo Frederiksen, L.M.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

52555 Issued in TX

Practice address

5554 Amistad St
Ft Worth, TX 76137-5365

Phone

(512) 785-0685

NPI assigned

May 6, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  TX

  Medicare reassignment

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1891130878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5554 AMISTAD ST",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761375365",
            "telephone_number": "512-785-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5554 AMISTAD ST",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761375365",
            "telephone_number": "512-785-0685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERIKSEN",
        "first_name": "KRISTIN",
        "middle_name": "JO",
        "credential": "L.M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-06",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "52555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Frazier, LPC
• Garrett Michael Frazier, D.O.
• Fred L. Spradley, D.D.S., M.S.D., P.a.
• Stephanie Fredeking
• Nicole Lea Frederick, DNP, APRN,ACCNS-AG
• Fredric D Johnson MD PA
• Rhett Keyser Fredric, MD
• Chelsea Victoria Fredrick, SLP
• Free to Be Counseling PLLC
• Katherine Isaiah Free, M.S., CCC-SLP

• Clinical Social Worker in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; 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.

Verify at the official NPI Registry.