MR. GARY J FREDERICKSEN (LICSW) – Clinical Social Worker, NPI 1700950557

MR. GARY J FREDERICKSEN (LICSW) is a healthcare provider. based in Lacey, Washington. specializing in Clinical Social Worker. They hold the professional credentials LICSW. They hold a License No. LW00004165 (WA). The NPI Number for MR. GARY J FREDERICKSEN (LICSW) is 1700950557

Main info

Male
Sole Proprietor
Name
MR. GARY J FREDERICKSEN (LICSW)
NPI
1700950557
Phone
(360) 704-7170
Address
4422 6TH AVE SE
Enumeration Date
20 November 2006
Last Update Date
20 July 2007
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for MR. GARY J FREDERICKSEN (LICSW)

  • 4422, 6th Avenue Southeast, Lacey, Thurston County, Washington, 98503, United States

    LACEY, WA 985031020

    Phone: (360) 704-7170

    Fax: (360) 412-4982

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98503)

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Reviews

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Frequently asked questions

How is MR. GARY J FREDERICKSEN (LICSW) identified in CMS data?
CMS-hosted NPPES data lists MR. GARY J FREDERICKSEN (LICSW) with NPI 1700950557.
Is MR. GARY J FREDERICKSEN (LICSW) listed as active for patients and plans?
The listing shows MR. GARY J FREDERICKSEN (LICSW) as active in the NPI system.
What is MR. GARY J FREDERICKSEN (LICSW)'s specialty?
The listing groups MR. GARY J FREDERICKSEN (LICSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What address line appears for MR. GARY J FREDERICKSEN (LICSW)?
MR. GARY J FREDERICKSEN (LICSW)'s geographic hint is Lacey, Washington in our summary view.
Why does MR. GARY J FREDERICKSEN (LICSW) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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