SUSAN M FREDRICKSON (NPI# 1548224744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548224744 |
| Entity Type | Individual |
| Full Name | SUSAN M FREDRICKSON |
| Credential | LMHC |
| Practice Address |
655 W Hwy 50 Suite 104 Clermont FL 34711-2913 |
| Mailing Address |
2950 Plaza Terrace Dr Orlando FL 32803-2825 |
| Practice Telephone | 3523945922 |
| Practice Fax Number | 3523606582 |
| Mailing Telephone | 3523945922 |
| Mailing Fax Number | 3523606582 |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
MH 4648 | FL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619305786 | Susan Fredrickson | Psychologist | 232 Rustling Willow St., Ute Mountain Ute Health Center, Towaoc, CO 81334-0049 | 2013-10-28 |
| 1174855399 | Susan D. Fredrickson | Marriage & Family Therapist | 1009b Solano Ave, Albany, CA 94706-1617 | 2010-02-12 |
| 1083818991 | Susan Anthony Fredrickson | Clinical Nurse Specialist | 23-25 Bay State Court, Brewster, MA 02631 | 2007-06-13 |
| Street Address |
655 W HWY 50 SUITE 104 |
| City | CLERMONT |
| State | FL |
| Zip Code | 34711-2913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417911785 | Lori T Shallcross | Social Worker | 655 W Hwy 50, Suite 104, Clermont, FL 34711-2913 | 2006-04-13 |
| 1982995411 | Bonnie B Enterprises, Inc | In Home Supportive Care | 655 W Hwy 50, Suite 103, Clermont, FL 34711-2982 | 2011-05-02 |
| 1619193513 | Andrea Maryann Bruno | Counselor | 655 W Hwy 50, Suite 104 Lifestream, Clermont, FL 34711-2982 | 2007-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316546344 | Latricia Richards-smith | Nurse Practitioner | 3301 Hancock Rd, Clermont, FL 34711 | 2020-10-21 |
| 1073130399 | Marissa Johnston | Behavioral Analyst | 355 Citrus Tower Blvd Ste 112, Clermont, FL 34711 | 2020-07-02 |
| 1649839432 | New Foundations Aba Therapy, LLC | Community/Behavioral Health | 4327 S Hwy 27 #176 Clermont, Clermont, FL 34711 | 2019-06-06 |
| 1275006504 | Innovative Medical Management Solutions LLC | Skilled Nursing Facility | 1775 Hooks Street, Clermont, FL 34711 | 2019-01-09 |
| 1851867766 | Chantal P Baptiste | Nurse Practitioner | 2040 Oakley Seaver Dr Ste 300, Clermont, FL 34711 | 2018-10-17 |
| 1346739539 | Jennifer Brennan | Behavior Technician | 365 Citrus Tower Blvd Bldg Ste 106, Clermont, FL 34711 | 2018-05-03 |
| 1689163966 | Chelsea Strickland | Physical Therapy Assistant | 10037 Stockbridge St, Clermont, FL 34711 | 2018-05-02 |
| 1316448921 | Dana Renee Ottalagano | Counselor | 1635 E Highway 50 Ste 204, Clermont, FL 34711 | 2018-02-28 |
| 1306353842 | Center of Change Inc. | General Practice | 235 Citrus Tower Blvd Ste 104, Clermont, FL 34711 | 2018-01-05 |
| 1003328642 | Clermont Radiology LLC | Clinic/Center | 3725 South Highway 27, Suite 104, Clermont, FL 34711 | 2017-11-03 |
| Find all providers in zip 34711 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932729779 | Conscious Change,llc | Psychologist | 1626 Nightfall Dr, Clermont, FL 34711-2762 | 2020-04-22 |
| 1598019838 | Jaymes Gonzales | Psychologist | 19225 Us Highway 27, Clermont, FL 34715-9025 | 2012-11-08 |
| 1235250606 | Debbie Wennerstrom | Psychologist | 10939 Versailles Blvd, Clermont, FL 34711-7351 | 2007-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740224 | North Florida Collaborative Therapy | Psychologist | 9652 Morgan Creek Ct, Jacksonville, FL 32222-5808 | 2020-11-05 |
| 1922607381 | Michelle Mcnally | Psychologist | 6945 Halton Park Ln, Coconut Creek, FL 33073-2170 | 2020-10-18 |
| 1427665322 | Salubrious Psychological Services | Psychologist | 865 Nw 208th Cir, Pembroke Pines, FL 33029-1908 | 2020-09-25 |
| 1396351979 | Daniela Oliveira De Medeiros | Psychologist | 111 Majorca Ave # B, Coral Gables, FL 33134-4508 | 2020-09-19 |
| 1235744327 | Lisa Stewart | Psychologist | 13000 Bruce B Downs Blvd Bldg 68, Tampa, FL 33612-4745 | 2020-09-15 |
| 1265047047 | Anissa York | Psychologist | 6760 Congress Ave Apt 203, Boca Raton, FL 33487-1242 | 2020-09-09 |
| 1154935781 | Caressa Alice Slocum | Psychologist | 840 Dr M.l.k. Jr St N, St. Petersburg, FL 33705 | 2020-09-01 |
| 1497365399 | Julia L Sheffler | Psychologist | 1126b Lee Ave, Tallahassee, FL 32303-6508 | 2020-08-05 |
| 1801413315 | Steven David Macchione | Psychologist | 328 Nw 97th Ave, Plantation, FL 33324-7068 | 2020-06-30 |
| 1578180154 | Lory Jean Reyes | Psychologist | 1180 N Federal Hwy Ph 1608, Fort Lauderdale, FL 33304-1470 | 2020-06-30 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SUSAN M FREDRICKSON.
| 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.