MEDICARE: COURTNEY FRERICHS LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	00881	IA

General Provider Information

NPI Number	:	1407967524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY FRERICHS LMHC

Provider Business Mailing Address
First Line	:	7177 HICKMAN RD STE 3
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50322-4844
Country	:	US
Telephone Number	:	515-251-4900
Fax Number	:	515-251-7311

Provider Business Practice Location Address
First Line	:	409 KENYON RD STE C
Second Line	:
City	:	FORT DODGE
State	:	IA
Zip	:	50501-5718
Country	:	US
Telephone Number	:	515-573-3138
Fax Number	:	515-573-3130

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	06/10/2014

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Directions to “ COURTNEY FRERICHS LMHC” Practice Location

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