STEPHANIE FREDRICK (NPI# 1699223214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699223214 |
| Entity Type | Individual |
| Full Name | STEPHANIE FREDRICK |
| Other Name | STEPHANIE M SECORD |
| Credential | PHD, LLP |
| Practice Address |
1101 Health Professions Bldg Mt Pleasant MI 48859-0001 |
| Practice Telephone | 9897743904 |
| Practice Fax Number | 9897741891 |
| Mailing Telephone | 9897743904 |
| Mailing Fax Number | 9897741891 |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2016-09-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
6301016859 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | STATE LICENSE | 6301016859 | 01 |
| Street Address |
1101 HEALTH PROFESSIONS BLDG |
| City | MT PLEASANT |
| State | MI |
| Zip Code | 48859-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114008711 | Michael Gordon Stewart | Audiologist | 1101 Health Professions Bldg, Mt Pleasant, MI 48859-0001 | 2006-10-18 |
| 1003394974 | Annmarie L Bates | Speech-Language Pathologist | 1101 Health Professions Bldg, Mt Pleasant, MI 48859-0001 | 2018-08-02 |
| 1720529340 | Jamie Haines | Physical Therapist | 1101 Health Professions Bldg, Mt Pleasant, MI 48859-0001 | 2017-03-15 |
| 1376093336 | Michael Brooks | Assistant Behavior Analyst | 1101 Health Professions Bldg, Mt Pleasant, MI 48859-0001 | 2016-10-13 |
| 1700336013 | Christi Owens | Speech-Language Pathologist | 1101 Health Professions Bldg, Mt Pleasant, MI 48859-0001 | 2016-10-11 |
| 1265880660 | Alissa Vanderlaan | Audiologist | 1101 Health Professions Bldg, Mt Pleasant, MI 48859-0001 | 2016-05-26 |
| 1982061289 | Seth Whiting | Behavioral Analyst | 1101 Health Professions Bldg, Mt Pleasant, MI 48859-0001 | 2016-01-19 |
| 1073987616 | Central Michigan University | Psychologist | 1101 Health Professions Bldg, Ste 2105, Mt Pleasant, MI 48859-0001 | 2015-11-19 |
| 1619352564 | Jill Wisniewski | Physical Therapist | 1101 Health Professions Bldg, Mt Pleasant, MI 48859-0001 | 2015-07-21 |
| 1205238425 | Michael Hixson | Psychologist | 1101 Health Professions Bldg, Mt Pleasant, MI 48859-0001 | 2014-09-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598255481 | Kimberly Kay Wyse | Psychologist | 2520 S University Park Drive, Building D Caat Center, Mount Pleasant, MI 48859 | 2018-05-16 |
| 1255888558 | Central Michigan University | Behavioral Analyst | 600 E Preston, Mount Pleasant, MI 48859 | 2016-09-02 |
| 1992852461 | Christina Eyers | Specialist/Technologist | 1172 Hpb, Mt. Pleasant, MI 48859 | 2007-01-05 |
| 1922630763 | Michael Swabash | Student in an Organized Health Care Education/Training Program | 1280 E Campus Dr, Mount Pleasant, MI 48859 | 2020-02-10 |
| 1710332440 | Jennifer Barnstable | Speech-Language Pathologist | 301 Williamston Center Rd, Suite 800, Williamston, MI 48859 | 2016-05-02 |
| 1083798540 | Michael Anthony Nerbonne | Audiologist | 1101 Health Professions Building, Mount Pleasant, MI 48859 | 2006-10-24 |
| 1942818919 | Dominique Hope Dimatteo | Specialist/Technologist | 145c Rose Center, Mount Pleasant, MI 48859-0001 | 2020-07-16 |
| 1750913596 | Elizabeth Kay Edson | Student in an Organized Health Care Education/Training Program | 1280 East Camus Dr, Mt Pleasant, MI 48859-0001 | 2020-02-10 |
| 1528617438 | Marlene K Vandyke | Specialist/Technologist | 1203 Health Profession Building, Mt Pleasant, MI 48859-0001 | 2019-09-04 |
| 1093283608 | Sida Bai | Physician Assistant | 1280 E Campus Dr Central Michigan University, Mount Pleasant, MI 48859-0001 | 2018-11-13 |
| Find all providers in zip 48859 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396235321 | Robert Dale Wyse | Psychologist | Central Michigan University Sloan Hall 139, Mt Pleasant, MI 48859-0001 | 2018-05-15 |
| 1073987616 | Central Michigan University | Psychologist | 1101 Health Professions Bldg, Ste 2105, Mt Pleasant, MI 48859-0001 | 2015-11-19 |
| 1225258361 | Lucia T Horowitz | Psychologist | 1041 Johnnie Dodds Blvd, Suite 14b, Mt Pleasant, SC 29464 | 2007-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477161347 | Becky Ann Tiret | Psychologist | 6896 Pleasant Ridge Trl, Saginaw, MI 48603-8677 | 2020-07-16 |
| 1366092298 | Cheyne Stresky | Psychologist | 945 Watersedge Ct, Oxford, MI 48371-3682 | 2019-09-12 |
| 1801456819 | Kenneth Michael Pierson | Psychologist | 100 Bowne St Ne, Grand Rapids, MI 49505-4014 | 2019-06-20 |
| 1831675271 | Katlyn Ploss | Psychologist | 43155 Main St Ste 2300g, Novi, MI 48375-1889 | 2018-07-18 |
| 1205320728 | Ashley L Weinert | Psychologist | 27780 Novi Rd Ste 244, Novi, MI 48377-3427 | 2018-06-18 |
| 1598255481 | Kimberly Kay Wyse | Psychologist | 2520 S University Park Drive, Building D Caat Center, Mount Pleasant, MI 48859 | 2018-05-16 |
| 1306336466 | Jeremy Stembridge | Psychologist | 2520 University Park Bldg D, Mount Pleasant, MI 48858-4464 | 2018-05-15 |
| 1295231926 | Nina Marie Elmendorf-steele | Psychologist | 8966 Meadow Ln, Berrien Springs, MI 49103-1479 | 2018-04-02 |
| 1114396413 | Heather Marie Martin | Psychologist | 19190 Kinloch, Redford, MI 48240-2602 | 2015-09-17 |
| 1982001210 | Monica Kumar | Psychologist | 14266 Kingswood St, Riverview, MI 48193-7859 | 2014-12-02 |
| Find all providers with the same taxonomy | ||||
| City | MT PLEASANT |
| Zip Code | 48859 |
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| 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.