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General NPI Number Information
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NPI Number | 1063007102
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Entity Type | Individual
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Provider Name | CASEY C FREDERICK LCPC, LCPAT, LPC
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Gender | Female
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Dates
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Enumeration Date | 03/01/2021
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 8 BROOKES AVE STE 200
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City | GAITHERSBURG
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State | MD
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Zip | 20877-2799
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Country | US
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Telephone | 240-452-0872
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Fax |
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Provider Business Mailing Address
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Address Line | 396 ASH ST
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City | SAINT MARYS
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State | PA
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Zip | 15857-1552
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Country | US
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Telephone | 814-562-0224
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC13322
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | ATC360
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC017187
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License Number State | PA
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