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MICK FREDRICKSON LCSW
NPI 1104180520
Social Worker - Clinical in Albany, OR

Active since June 29, 2012PECOS Enrolled
425 2ND AVE SW STE 102, ALBANY, OR 97321(541) 286-3209(541) 704-0040 Get Directions Write a Review

NPPES record last updated: April 14, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 14, 2021, Apr 12, 2020, Nov 25, 2019 and 2 more (5 updates tracked since 2019).

About Mick Fredrickson Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICK FREDRICKSON LCSW (NPI 1104180520) is an individual clinical provider in Albany, Oregon, licensed in Oregon (L6743) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS and maintains a secondary practice location in Albany.

NPPES Registry Identity

NPI1104180520
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMICK FREDRICKSONCredential: LCSW
Location Address425 2ND AVE SW STE 102Albany, OR 97321-2483
Mailing Address425 2nd Ave Sw Ste 102Albany, OR 97321-2483 · (541) 286-3209 · Fax (541) 704-0040
Phone(541) 286-3209
Fax(541) 704-0040
Sole ProprietorYes
Enumeration DateJune 29, 2012
Last NPPES UpdateApril 14, 20215 updates tracked since enumeration
NPPES CertifiedApril 14, 2021
✔ NPI 1104180520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in OR · L6743
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
425 2ND AVE SW STE 102, Albany, OR 97321
Open in Google Maps ↗

Secondary Practice Location 1

Location 1425 2nd Ave SW Ste 101DAlbany, OR 97321-2483 · Phone (541) 220-8223 · Fax (541) 833-0419

Other Identifiers 1

Medicaid500710040OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mick Fredrickson Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mick Fredrickson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Reclaim Life, LLC
Same address
Clinical
425 2ND AVE SW STE 102
Albany, OR 97321
  • Reassigned Medicare billing, Oregon enrollment
  • 8 clinicians in this Medicare group
NPI 1043788896 (541) 286-3209

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97321 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.96 – $166.64
Typical copayment $0.00 (range $13.74 – $41.66)
Most-billed visit code NA
Established Patient
$68.64 typical visit price
range $17.68 – $136.19
Typical copayment $17.16 (range $4.42 – $34.04)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BARRYLEE COYNE LCSW
Counselor (Mental Health)
425 2ND AVE SW STE 102
ALBANY, OR 97321
Benton County (541) 286-3209
RECLAIM LIFE, LLC
Social Worker (Clinical)
425 2ND AVE SW STE 102
ALBANY, OR 97321
Benton County (541) 286-3209
CONNIE AMANDA SMITH-WELLS MSW
Counselor (Mental Health)
425 2ND AVE SW STE 102
ALBANY, OR 97321
Benton County (541) 286-3209
DEANNA DOWLIN
Counselor (Mental Health)
425 2ND AVE SW STE 102
ALBANY, OR 97321
Benton County (541) 286-3209
MICHELLE LA CASSE LPC
Counselor
425 2ND AVE SW STE 102
ALBANY, OR 97321
Benton County (541) 286-3209
JOHN GILBERT MS
Counselor (Mental Health)
425 2ND AVE SW STE 102
ALBANY, OR 97321
Benton County (541) 286-3209
CHRISTINA M BASS
Counselor (Mental Health)
425 2ND AVE SW STE 102
ALBANY, OR 97321
Benton County (541) 286-3209

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mick Fredrickson's NPI number?

The NPI number for Mick Fredrickson is 1104180520. It was assigned to this individual provider in the NPPES registry on June 29, 2012.

Where is Mick Fredrickson located?

Mick Fredrickson practices at 425 2nd Ave SW Ste 102, Albany, OR 97321. The listed phone number is (541) 286-3209.

What is Mick Fredrickson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Mick Fredrickson enrolled in Medicare?

Yes. Mick Fredrickson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mick Fredrickson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mick Fredrickson reassigns Medicare benefits to Reclaim Life, LLC (Albany, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mick Fredrickson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mick Fredrickson accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Mick Fredrickson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mick Fredrickson was last updated on April 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.