Individual provider Active NPI

Gerard Ernest Fredette, L.I.C.S.W.

  • Mental Health Counselor
  • Holyoke, MA
National Provider Identifier
1912043167
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1025997 Issued in MA
Practice address
230 Maple St
Holyoke, MA 01040-5144
Phone
(413) 532-9446
NPI assigned
Jan 29, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1025997 MA Primary

Addresses

Primary practice location

230 Maple St
Holyoke, MA 01040-5144

Mailing address

141 Beauchamp Ter
Chicopee, MA 01020-2534
Phone (413) 594-8399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20050926001208 MA Practitioner - Clinical Social Worker 8123052339 Reassigns benefits to 1 organization
Practice locations: East Longmeadow, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Connecticut School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

103 Myron St
Suite a
West Springfield, MA 01089-1485
Phone (413) 592-1980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1025997MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Health Services, LLC CurrentSince May 16, 2023 Accepting new patients

Locations

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

103 Myron St
Ste A
West Springfield, MA 01089
Phone (978) 388-1010

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912043167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 BEAUCHAMP TER",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010202534",
            "telephone_number": "413-594-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MAPLE ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010405144",
            "telephone_number": "413-532-9446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDETTE",
        "first_name": "GERARD",
        "middle_name": "ERNEST",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "1025997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holyoke, MA

Sources for this page

Verify at the official NPI Registry.