Provider Demographics
NPI:1407967524
Name:FRERICHS, COURTNEY (LMHC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:FRERICHS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7177 HICKMAN RD STE 3
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50322-4844
Mailing Address - Country:US
Mailing Address - Phone:515-251-4900
Mailing Address - Fax:515-251-7311
Practice Address - Street 1:409 KENYON RD STE C
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-5718
Practice Address - Country:US
Practice Address - Phone:515-573-3138
Practice Address - Fax:515-573-3130
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00881101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health