Raymond Gene Fredrickson, MSW, LICSW, SUDPT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61238408 Issued in WA

Practice address

104 S Freya St
Spokane, WA 99202-4862

Phone

(509) 964-1590

NPI assigned

Jan 11, 2021

Last updated

Sep 8, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Beyond Behavioral Health LLCGroup PAC ID 3274951579, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.22 of 100Reported as group

Quality

72.08

Promoting interoperability

70

Improvement activities

40

Cost

66.98

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beyond Behavioral Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Spokane, WA
  • NPI 1033728415

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  WA

  Medicare reassignment Care Compare group NPD
• Harbor Youth and Family Counseling

  • Mental Health Counselor
  • Tukwila, WA
  • NPI 1205466265
  NPD

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1902495351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S FREYA ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024862",
            "telephone_number": "509-992-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S FREYA ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024862",
            "telephone_number": "509-964-1590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKSON",
        "first_name": "RAYMOND",
        "middle_name": "GENE",
        "credential": "MSW, LICSW, SUDPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-11",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61238408",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO61137490",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "BeyondBehavioralHealth.com",
            "affiliation": "N",
            "endpointDescription": "URL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "104 S Freya St",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992024862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lola K. Frederick
• Miranda N Frederick, DPT
• Nayeli Aide Fredericks, M.A., BCBA
• Marci Jane Fredricks
• Bridget Fredrickson, COTA/L
• Free 2 Achieve PLLC (Uplift ADHD Clinic)
• Free Air Life, Inc.
• Free Motion Physical Therapy LLC
• Gillian Freeby
• McKenna Freed, ARNP

• Clinical Social Worker in Spokane, WA
• Providers in Spokane, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.