Frederick, Chad

Frederick, Chad is an individual health care provider with primary practice located at 617 S Trenton St , Ruston LA 71270-5040. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Frederick, Chad can be contacted via phone (318) 251-4659.

Contact Information

Primary practice address
617 S Trenton St Ruston LA 71270-5040
Phone: (318) 251-4659
Fax: (318) 251-4659
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 3129 Louisiana

Profile Details

NPI number 1417362278
LBN Legal business name Frederick, Chad
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2014
Last updated Jun 30th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417362278 NPPES
Louisiana MEDICAID 1345897

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