Kathleen A Frederick, LICSW, CACII is a
Social Worker - Clinical based in Portland, Oregon. Kathleen A Frederick is licensed to practice in Washington (license number LW 60248502) and her current practice location is
3710 Sw Us Veterans Hospital Road, Portland, Oregon. She can be reached at her office (for appointments etc.) via phone at
(360) 696-4061.
NPI number for Kathleen A Frederick is 1417257759 and her current mailing address is 3710 Sw Us Veterans Hospital Road, P.o.box 1035, Portland, Oregon. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1417257759.
Healthcare Provider's Profile
| Full Name | Kathleen A Frederick |
|---|
| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 3710 Sw Us Veterans Hospital Road, Portland, Oregon |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1417257759
- Provider Enumeration Date: 11/02/2010
- Last Update Date: 08/06/2013
Medical Identifiers
Medical identifiers for Kathleen A Frederick such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1417257759 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 6333 (Colorado) | Secondary |
| 1041C0700X | Social Worker - Clinical | 1249 (Colorado) | Secondary |
| 1041C0700X | Social Worker - Clinical | LW 60248502 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kathleen A Frederick is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kathleen A Frederick, LICSW, CACII
3710 Sw Us Veterans Hospital Road, P.o.box 1035,
Portland, OR 97207
Ph: (360) 696-4061 | Kathleen A Frederick, LICSW, CACII
3710 Sw Us Veterans Hospital Road,
Portland, OR 97207
Ph: (360) 696-4061 |
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