NPIMap

Organization Active NPI

Robert M. Fredrick, LCSW,PC

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1992076988
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000144 Issued in GA
Legal business name
ROBERT M. FREDRICK, LCSW,PC
Practice address
2801 Buford Hwy NE
Suite 508
Atlanta, GA 30329-2149
Phone
(404) 636-1108
Fax
(404) 636-9482
NPI assigned
Jan 23, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Authorized official

Name
Mr. Robert M Fredrick, MSWNPI 1316001357
Title
President
Phone
(404) 636-1108

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 000144 GA Primary

Addresses

Primary practice location

2801 Buford Hwy NE
Suite 508
Atlanta, GA 30329-2149

Mailing address

2801 Buford Hwy NE
Suite 508
Atlanta, GA 30329-2149
Phone (404) 636-1108

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1992076988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 BUFORD HWY NE",
            "address_2": "SUITE 508",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292149",
            "telephone_number": "404-636-1108",
            "fax_number": "404-636-9482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 BUFORD HWY NE",
            "address_2": "SUITE 508",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292149",
            "telephone_number": "404-636-1108",
            "fax_number": "404-636-9482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT M. FREDRICK, LCSW,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-23",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "FREDRICK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-636-1108",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "000144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.