KATHLEEN A FREDERICK (NPI# 1417257759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417257759 |
| Entity Type | Individual |
| Full Name | KATHLEEN A FREDERICK |
| Credential | LICSW, CACII |
| Practice Address |
3710 Sw Us Veterans Hospital Road Portland OR 97207 |
| Mailing Address |
3710 Sw Us Veterans Hospital Road P.o.box 1035 Portland OR 97207 |
| Practice Telephone | 3606964061 |
| Mailing Telephone | 3606964061 |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2013-08-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
6333 | CO | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LW 60248502 | WA | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
1249 | CO | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689789778 | Kathleen Mary Frederick | Physical Therapist | 506 Marsh Rd, Wilmington, DE 19809-2121 | 2006-08-20 |
| 1467905869 | Kathleen C Frederick | Audiologist | 113 E Long Lake Rd, Suite B, Troy, MI 48085-5500 | 2016-08-02 |
| 1568746691 | Kathleen Parker Frederick | Counselor | 2409 Homer Clayton Dr, Guntersville, AL 35976-2207 | 2011-10-07 |
| 1710294251 | Kathleen Elizabeth Frederick | Massage Therapist | 325 S Sullivan Rd, Suite B, Spokane Valley, WA 99037-6000 | 2010-09-03 |
| Street Address |
3710 SW US VETERANS HOSPITAL ROAD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699736645 | Kerry Noelle Rhyne | Internal Medicine | 3710 Sw Us Veterans Hospital Road, P3-med, Portland, OR 97239 | 2006-03-29 |
| 1003375551 | Rebecca X Casanova | Social Worker | 3710 Sw Us Veterans Hospital Road, P3mhc, Portland, OR 97239 | 2019-03-14 |
| 1992273346 | Kelly Ann Smith | Dietitian, Registered | 3710 Sw Us Veterans Hospital Road, Portland, OR 97239-2964 | 2018-11-04 |
| 1306198346 | Mary Newgard Benson | Nurse Practitioner | 3710 Sw Us Veterans Hospital Road, Portland, OR 97239 | 2012-10-15 |
| 1407123219 | Kathleen Ann Fuglee | Clinical Nurse Specialist | 3710 Sw Us Veterans Hospital Road, Primary Care Room F 120, Portland, OR 97207-1034 | 2011-11-22 |
| 1457645962 | Cathy Olbrich-tenney | Social Worker | 3710 Sw Us Veterans Hospital Road, Vamc/p35c, Portland, OR 97207 | 2011-06-01 |
| 1568515781 | Gordon Jin Wong | Pharmacist | 3710 Sw Us Veterans Hospital Road, Portland, OR 97239 | 2007-01-19 |
| 1194812800 | Barbara Lee Trentadue | Physical Therapy Assistant | 3710 Sw Us Veterans Hospital Road, Portland, OR 97207-1034 | 2006-10-06 |
| 1447344015 | Erin Kathleen Bookout | Speech-Language Pathologist | 3710 Sw Us Veterans Hospital Road, Portland, OR 97239 | 2006-10-03 |
| 1548353527 | Karen Emi Inaba | Nurse Practitioner | 3710 Sw Us Veterans Hospital Road, Mail Code P3 Gp1 Gpsy Portland Veterans Affairs Medical, Portland, OR 97239 | 2006-10-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134285620 | Natalia Hanavan | Orthotist | 3710 Sw Us Veteran's Hospital Rd, Portland, OR 97207 | 2006-12-29 |
| 1659435915 | Mary Catherine Russell | Nurse Practitioner | 3710 Sw Us Veterans Hosp Rd, Portland, OR 97207 | 2006-12-21 |
| 1467545996 | Michael Philip Resnick | Psychiatry & Neurology | 3181 Ssam Jackson Park Rd, Portland, OR 97207 | 2006-10-02 |
| 1609969435 | Patricia A Sosnovec | Nurse Practitioner | 3710 Sw Us Veterans Hospital Road V3-mhd, Portland, OR 97207 | 2006-10-02 |
| 1447358866 | Alison Elaine Hopkins | Nurse Practitioner | 3710 Sw Us, Veterans Hospital Road, Portland, OR 97207 | 2006-09-20 |
| 1518060805 | Michael Vernon Eddington | Social Worker | Va Medical Center(v3cnh), Sam Jackson Blvd, Portland, OR 97207 | 2006-09-05 |
| 1194827493 | Charlotte Ann Sunderland | Nurse Practitioner | Veterans Medical Center, P3 Card, Division of Cardiolog, Us Veterans Hospital Road, Portland, OR 97207 | 2006-09-05 |
| 1134237621 | Linda Louise Humphrey | Internal Medicine | 3710 Sw Us Vetserans Hospital Rd, Portland, OR 97207 | 2006-08-26 |
| 1821105222 | Gina L Ortola | Psychologist | Portland Vamc, 3710 Sw Us Veterans Hospital Road, Portland, OR 97207 | 2006-08-23 |
| 1841307238 | Matthew Peter Kaul | Physical Medicine & Rehabilitation | 3710 Sw Us Veteran's Hospital Rd., Portland, OR 97207 | 2006-08-23 |
| Find all providers in zip 97207 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063012649 | Kathleen Russell | Social Worker | 7700 Sw Garden Home Rd Apt 23, Portland, OR 97223-7496 | 2020-10-31 |
| 1275131534 | Alice Hacker | Social Worker | 14702 Se Rhone St, Portland, OR 97236-2557 | 2020-10-09 |
| 1598372070 | Kristin Elizabeth Hajny | Social Worker | 9343 Sw Camille Ter, Portland, OR 97223-7042 | 2020-09-28 |
| 1821605759 | Melanie Smith | Social Worker | 4210 N Juneau St, Portland, OR 97203-2063 | 2020-09-24 |
| 1871100867 | Purely Spirit Holistic Health, LLC | Social Worker | 226 Stevens Ave Apt 9, Portland, ME 04102-2263 | 2020-09-24 |
| 1023624780 | Flourish Counseling and Consulting LLC | Social Worker | 8401 Ne Halsey St Ste 107, Portland, OR 97220-5670 | 2020-09-18 |
| 1245845130 | Crescent Psychotherapy | Social Worker | 168 Neal St, Portland, ME 04102-3343 | 2020-09-09 |
| 1861007676 | Yvonne Recchia | Social Worker | 5257 Ne Mlk, Portland, OR 97211-3282 | 2020-09-09 |
| 1447864327 | Gordon Keepers | Social Worker | 3181 Sw Sam Jackson Park Rd # Uhs8-l, Portland, OR 97239-3098 | 2020-09-08 |
| 1609484187 | Julie Pratt | Social Worker | 14 Culver Ln, Portland, CT 06480-1323 | 2020-07-21 |
| Find all providers in PORTLAND | ||||
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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.