Stacey Lynn Fredericks

Clinical Social Worker · Oak Lawn, IL

Individual Active NPI

NPI number 1023360989

Practice location

4700 W 95TH St Ste 205
Oak Lawn, IL 60453-2574
Phone
(708) 684-7999

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NPI record

NPI
1023360989
Entity type
Individual (Type 1)
Enumeration date
October 2, 2012
Last updated
February 28, 2023
Certified
February 28, 2023
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Clinical Social Worker Primary 1041C0700X 149.025334 IL
Student in an Organized Health Care Education/Training Program 390200000X — —

About Stacey Fredericks

Stacey Lynn Fredericks is a healthcare provider registered in the NPI registry with the primary taxonomy Clinical Social Worker (code 1041C0700X). The practice location is 4700 W 95TH St Ste 205, Oak Lawn, IL 60453-2574. The NPI number 1023360989 was assigned on October 2, 2012 and the record was last updated on February 28, 2023.

Stacey Fredericks lists a license in the registry: #149.025334 (IL) for Clinical Social Worker. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Stacey Lynn Fredericks?

The NPI number is 1023360989.

What is the phone number of Stacey Fredericks?

The phone number listed for the practice location is (708) 684-7999.

Where is Stacey Fredericks located?

4700 W 95TH St Ste 205, Oak Lawn, IL 60453-2574.

What is the taxonomy code for Stacey Fredericks?

The primary taxonomy code is 1041C0700X – Clinical Social Worker; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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