STEPHANIE FREDRICK


Address: 1101 Health Professions Bldg, Mt Pleasant, MI 48859-0001
Phone: 9897743904

STEPHANIE FREDRICK (NPI# 1699223214) 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) 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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TS0200X Psychologist
Specialization: School
6301016859 MI Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MI STATE LICENSE 6301016859 01

Office Location

Street Address 1101 HEALTH PROFESSIONS BLDG
City MT PLEASANT
State MI
Zip Code 48859-0001

Providers in the same location

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
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Providers in the same zip code

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 Information

Taxonomy Code 103TS0200X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization School

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

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City MT PLEASANT
Zip Code 48859

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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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