SUSAN ANTHONY FREDRICKSON (NPI# 1083818991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083818991 |
| Entity Type | Individual |
| Full Name | SUSAN ANTHONY FREDRICKSON |
| Credential | R.N., M.S.N., C.S. |
| Practice Address |
23-25 Bay State Court Brewster MA 02631 |
| Practice Telephone | 5082407964 |
| Practice Fax Number | 5082405448 |
| Mailing Telephone | 5082407964 |
| Mailing Fax Number | 5082405448 |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2010-03-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
277918 | MA | Physician Assistants & Advanced Practice Nursing 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 |
| 1548224744 | Susan M Fredrickson | Psychologist | 655 W Hwy 50, Suite 104, Clermont, FL 34711-2913 | 2006-04-14 |
| Street Address |
23-25 BAY STATE COURT |
| City | BREWSTER |
| State | MA |
| Zip Code | 02631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205925450 | Michael Lee Taylor | Social Worker | 23-25 Bay State Court, Brewster, MA 02631 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548813850 | Pleasant Bay of Brewster Rehab Center LLC | Skilled Nursing Facility | 383 South Orleans Road, Brewster, MA 02631 | 2019-07-17 |
| 1669972790 | Julie Lynne Mollica | Social Worker | 456 Flax Pond Road, Brewster Treatment Program, Old Colony Ymca, Brewster, MA 02631 | 2018-02-15 |
| 1295244168 | Michele Louise Oconnor | Occupational Therapist | 1721 Long Pond Road, Brewster, MA 02631 | 2017-09-23 |
| 1356799902 | Katherine Drach Reilly | Behavioral Analyst | 63 Brook Trail Rd, Brewster, MA 02631 | 2016-05-24 |
| 1407214901 | Md Visits LLC | Emergency Medicine | 162 Highland Moors Dr., Brewster, MA 02631 | 2016-01-29 |
| 1720350390 | Kevin Whelley | Counselor | 21 Cross Street, Brewster, MA 02631 | 2012-01-30 |
| 1518238609 | Pleasant Bay Health and Wellness Center LLC | Physical Therapist | 64 Woodlands Way, Brewster, MA 02631 | 2012-01-20 |
| 1184740953 | Jacs Ops IIi, Inc | Assisted Living Facility | 855 Harwich Road, Brewster, MA 02631 | 2007-03-22 |
| 1184763997 | Beverly Ann Biondi | Physical Therapist | 84 Underpass Rd, Brewster, MA 02631 | 2007-02-06 |
| 1679646384 | Paul James Tausek | Social Worker | 25 Breakwater Rd, Brewster, MA 02631 | 2006-11-17 |
| Find all providers in zip 02631 | ||||
| Taxonomy Code | 364SP0809X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935809 | Anne-marie Barron | Clinical Nurse Specialist | 9 Kahler Ave, Milton, MA 02186-1519 | 2020-06-07 |
| 1306467139 | Kathleen Mary Daly | Clinical Nurse Specialist | 22 Priscilla Ln, Duxbury, MA 02332-5101 | 2020-05-04 |
| 1407325541 | New Directions Behavioral Health LLC | Clinical Nurse Specialist | 10 Ash St, Danvers, MA 01923-2749 | 2018-11-19 |
| 1457894628 | Psyche1001 Learn Grow Change LLC | Clinical Nurse Specialist | 638 Adamsville Rd, Suite 1001, Westport, MA 02790-5031 | 2016-11-21 |
| 1841642725 | Joyce Daqnal Shields | Clinical Nurse Specialist | 132 Oakley Rd, Belmont, MA 02478-2734 | 2016-07-05 |
| 1386004075 | Jane Bloom | Clinical Nurse Specialist | 95 Golden Hill, Lee, MA 01238-9132 | 2016-02-24 |
| 1255722716 | Carol Vivori | Clinical Nurse Specialist | 132 Mass Moca Way, North Adams, MA 01247-2446 | 2015-02-05 |
| 1982995262 | Linda Louise Darbyshire | Clinical Nurse Specialist | 60 Munson Meeting Way Ste I, Psychiatric Collaborative, Chatham, MA 02633-1992 | 2011-04-21 |
| 1093020091 | Suzanne Elizabeth Bergeron | Clinical Nurse Specialist | 2 Administration Rd, Bridgewater, MA 02324-3230 | 2010-08-13 |
| 1467774356 | Mindful Wellbeing, LLC | Clinical Nurse Specialist | 11 Jillson Way, East Sandwich, MA 02537-1265 | 2010-02-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SUSAN ANTHONY 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.