MEDICARE: KIMBERLY FREDERICKS LPC

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	101YP2500X	Professional Counselor	37PC00321300	NJ
2	101YP2500X	Professional Counselor	PC003571	PA

General Provider Information

NPI Number	:	1982033643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY FREDERICKS LPC

Provider Business Mailing Address
First Line	:	3895 ADLER PL STE 180
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18017-8994
Country	:	US
Telephone Number	:	484-542-5058
Fax Number	:

Provider Business Practice Location Address
First Line	:	3895 ADLER PL STE 180
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18017-8994
Country	:	US
Telephone Number	:	484-542-5058
Fax Number	:

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

Provider Enumeration Date	:	11/04/2013
Last Update Date	:	06/18/2026

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Directions to “ KIMBERLY FREDERICKS LPC” Practice Location

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