Timothy Fredrickson, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180-001837 Issued in IL

Practice address

1639 N Alpine Rd Ste 403
Rockford, IL 61107-1440

Phone

(815) 229-7102

Fax

(815) 229-7108

NPI assigned

Feb 17, 2006

Sex

Male

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 IL

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

Mental Health Counselor

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Fredrickson Counseling P C

  • Professional Counselor
  • Rockford, IL
  • NPI 1700650793
  Medicare reassignment NPD

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1922073642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1639 N ALPINE RD STE 403",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071440",
            "telephone_number": "815-229-7102",
            "fax_number": "815-229-7108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 N ALPINE RD STE 403",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071440",
            "telephone_number": "815-229-7102",
            "fax_number": "815-229-7108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKSON",
        "first_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2023-11-06",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-001837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yohannes G Fre, MSN FNP-BC
• Luke Richard Frederick, MD
• Fredric C. Kullberg, M.D.S.C.
• Nancy Fredrick, LCPC
• Fredrickson Counseling P C
• Tonya Free, CNA
• Kathleen Marie Freeburg, MS LMFT
• Nancy Freedlund, RD, LDN
• Freedom Vision Centers LLC
• Lawrence Adrian Freeman, FNP

• Professional Counselor in Rockford, IL
• Providers in Rockford, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.