Frederick, Elizabeth R
Frederick, Elizabeth R is an individual health care provider with primary practice located at 1100 W 21St Street , Clovis NM 88101. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Frederick, Elizabeth R can be contacted via phone (575) 769-2345.Contact Information
Primary practice address
1100 W 21St Street
Clovis NM 88101
Phone: (575) 769-2345
Fax: (575) 769-9013
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | C-11341 | New Mexico |
Profile Details
| NPI number | 1073849246 |
|---|---|
| LBN Legal business name | Frederick, Elizabeth R |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 23rd, 2009 |
| Last updated | Nov 1st, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073849246 | NPPES |
| New Mexico | MEDICAID | 62430360 |
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