Provider Demographics
NPI:1275251266
Name:FREDERICK THERAPY, LLC
Entity Type:Organization
Organization Name:FREDERICK THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:ANDREWS
Authorized Official - Last Name:MCADAM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:240-575-1810
Mailing Address - Street 1:147 RAINBOW DR # 4774
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77399-1047
Mailing Address - Country:US
Mailing Address - Phone:301-471-8822
Mailing Address - Fax:443-957-9004
Practice Address - Street 1:316 VILLA DR # 4774
Practice Address - Street 2:
Practice Address - City:BOX ELDER
Practice Address - State:SD
Practice Address - Zip Code:57719-2023
Practice Address - Country:US
Practice Address - Phone:301-471-8822
Practice Address - Fax:443-957-9004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty