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General NPI Number Information
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NPI Number | 1003020249
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Entity Type | Individual
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Provider Name | HEATHER FREDERICK LPC, CAADC, CCS
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Gender | Female
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 7355 LEWIS AVE STE C
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City | TEMPERANCE
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State | MI
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Zip | 48182-1465
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Country | US
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Telephone | 734-224-3761
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Fax |
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Provider Business Mailing Address
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Address Line | 7250 DOUGLAS RD
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City | LAMBERTVILLE
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State | MI
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Zip | 48144-9488
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Country | US
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Telephone | 734-652-6782
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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