Fredericks, Paulette
Fredericks, Paulette is an sole proprietor health care provider with primary practice located at 20000 Horizon Way, Suite 500 , Mt. Laurel NJ 08054. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical, Agencies / Community/Behavioral Health, Behavioral Health & Social Service Providers / Counselor. Agencies / Community/Behavioral Health is her primary health care specialty. Fredericks, Paulette can be contacted via phone (856) 269-0019.Contact Information
Primary practice address
20000 Horizon Way, Suite 500
Mt. Laurel NJ 08054
Phone: (856) 269-0019
Fax: (856) 497-2525
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 44SC05226600 | New Jersey |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 44SC055226600 | New Jersey |
| Agencies / Community/Behavioral Health | 251S00000X | 44SC05226600 | New Jersey |
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 44SC05226600 | New Jersey |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | ||
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | ||
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | ||
| Agencies / Community/Behavioral Health | 251S00000X | New Jersey |
Profile Details
| NPI number | 1629103551 |
|---|---|
| LBN Legal business name | Fredericks, Paulette |
| Credentials | MSW, LCSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 22nd, 2007 |
| Last updated | Nov 2nd, 2015 - about 10 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 | 1629103551 | NPPES |
| New Jersey | MEDICAID | 0053643 |
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