MEDICARE: NANETTE ARONE FREDERICKS LCSW

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	1041C0700X	Clinical Social Worker	34002112A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871599761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANETTE ARONE FREDERICKS LCSW

Provider Business Mailing Address
First Line	:	310 N MICHIGAN ST STE 204
Second Line	:
City	:	PLYMOUTH
State	:	IN
Zip	:	46563-1774
Country	:	US
Telephone Number	:	574-936-3031
Fax Number	:	866-311-5621

Provider Business Practice Location Address
First Line	:	310 N MICHIGAN ST STE 204
Second Line	:
City	:	PLYMOUTH
State	:	IN
Zip	:	46563-1774
Country	:	US
Telephone Number	:	574-936-3031
Fax Number	:	866-311-5621

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

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	01/04/2011

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Directions to “ NANETTE ARONE FREDERICKS LCSW” Practice Location

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