MICK FREDRICKSON


Address: 425 2nd Ave Sw Ste 102, Albany, OR 97321-2483
Phone: 5412863209

MICK FREDRICKSON (NPI# 1104180520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1104180520
Entity Type Individual
Full Name MICK FREDRICKSON
Credential LCSW
Practice Address 425 2nd Ave Sw Ste 102
Albany
OR 97321-2483
Mailing Address 3065 25th Ave Se
Albany
OR 97322-8812
Practice Telephone 5412863209
Practice Fax Number 5417040040
Mailing Telephone 5412208223
Mailing Fax Number 5418330419
Enumeration Date 2012-06-29
Last Update Date 2020-04-12
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1041C0700X Social Worker
Specialization: Clinical
L6743 OR Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
OR 500710040 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
425 2nd Ave Sw Ste 101b, Albany, OR 973212483 5412863209 5417040040
425 2nd Ave Sw Ste 101d, Albany, OR 973212483 5412208223 5418330419

Office Location

Street Address 425 2ND AVE SW STE 102
City ALBANY
State OR
Zip Code 97321-2483

Providers in the same location

NPI Name Taxonomy Address Enumeration
1548879620 Susan Mae Shol Social Worker 425 2nd Ave Sw Ste 102, Albany, OR 97321-2483 2020-07-24
1043788896 Reclaim Life, LLC Social Worker 425 2nd Ave Sw Ste 102, Albany, OR 97321-2483 2018-11-09
1386099398 Deidre Ann Lafferty Social Worker 425 2nd Ave Sw Ste 102, Albany, OR 97321-2483 2016-04-27

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1730659228 Waverly Assisted Living, LLC In Home Supportive Care 2853 Salem Ave Se Ste A, Albany, OR 97321 2018-11-28
1558838706 Greater Albany Public Schools 8j Local Education Agency (LEA) 718 Seventh Ave. Sw, Albany, OR 97321 2018-10-25
1396232237 Chiho Sakamoto Gunton Social Worker 227 Sw 3rd Avenue, Albany, OR 97321 2018-04-17
1700333184 Albany General Hospital Clinic/Center 534 Pleasant View Way Nw, Suite 400, Albany, OR 97321 2016-09-02
1811373772 Katrin M Ridge Pharmacist 1010 7th Ave. Sw., Albany, OR 97321 2015-08-03
1720485527 Heartsong Counseling Counselor 425 Sw 2nd Ave. #203, Albany, OR 97321 2014-11-24
1619386604 Courtney Ann Miller Dentist 2815 Willetta St, Suite A-1, Albany, OR 97321 2014-08-05
1346664810 Jeffrey Othniel Nordtvedt Case Manager/Care Coordinator 2730 Sw Pacific Boulevard, Albany, OR 97321 2014-02-05
1174872022 Albany General Hospital Internal Medicine 631 Southwest Elm Street, Suite 200, Albany, OR 97321 2012-09-06
1144594532 Russell Travis Pharmacist 1177 Waverly Dr, Albany, OR 97321 2012-03-02
Find all providers in zip 97321

Taxonomy Information

Taxonomy Code 1041C0700X
Grouping Behavioral Health & Social Service Providers
Classification Social Worker
Specialization Clinical

Taxonomy Definition

A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1831790195 Emily Phyllis Wood Social Worker 6 Automation Ln Ste 112/113, Albany, NY 12205-1668 2020-11-03
1457977043 Latoya Palmer Social Worker 742 S Pearl St, Albany, NY 12202-1016 2020-06-19
1982226627 Camille Hehn Social Worker 527 Bradford St, Albany, NY 12206-1432 2020-05-16
1467073916 Ashley Mary Millington Social Worker 20 Bauer Dr, Albany, NY 12205-5002 2020-05-06
1710512264 Ashley Nicole Hall Social Worker 3418 Aristedes Rd, Albany, GA 31721-7745 2020-03-05
1497380133 Diane Hamon Social Worker 2516 Dawson Rd Ste D, Albany, GA 31707-2304 2020-03-03
1205469392 Cornell Andre Morris Social Worker Albany Stratton Va Medical Center, 113 Holland Avenue, Albany, NY 12208 2020-02-17
1588229017 Lachandra Johnson Fields Social Worker 2411 Bettys Dr, Albany, GA 31705-4303 2019-05-09
1245796580 Amanda Ricciardi Social Worker 1229 Central Ave, Albany, NY 12205-5340 2019-02-12
1538649785 Courtney Kenneally Mazzone Social Worker 435 New Karner Rd Ste 17, Albany, NY 12205-5841 2018-08-17
Find all providers in ALBANY

Competitor

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City ALBANY
Zip Code 97321

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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