TONY DAVID FREDERICKS II
NPI 1174236624
Peer Specialist in Elizabethtown, KY

Active since December 29, 2022
100 PAR LN STE 102, ELIZABETHTOWN, KY 42701(270) 312-2500 Get Directions Write a Review

NPPES record last updated: December 29, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Tony David Fredericks Ii NPPES

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

TONY DAVID FREDERICKS II (NPI 1174236624) is an individual peer specialist in Elizabethtown, Kentucky and active in the NPI registry since December 2022.

NPPES Registry Identity

NPI1174236624
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameTONY DAVID FREDERICKS II
Location Address100 PAR LN STE 102Elizabethtown, KY 42701-9059
Mailing Address100 Par Ln Ste 102Elizabethtown, KY 42701-9059
Sole ProprietorYes
Enumeration DateDecember 29, 2022
NPPES CertifiedDecember 29, 2022
NPI 1174236624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

100 PAR LN STE 102, Elizabethtown, KY 42701

Other Providers at the Same Location NPPES 20

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

Peer Specialist
100 PAR LN STE 102
ELIZABETHTOWN, KY 42701
Social Worker (Clinical)
100 PAR LN STE 102
ELIZABETHTOWN, KY 42701
Peer Specialist
100 PAR LN STE 102
ELIZABETHTOWN, KY 42701
Peer Specialist
100 PAR LN STE 102
ELIZABETHTOWN, KY 42701
Peer Specialist
100 PAR LN STE 102
ELIZABETHTOWN, KY 42701
Peer Specialist
100 PAR LN STE 102
ELIZABETHTOWN, KY 42701
Peer Specialist
100 PAR LN STE 102
ELIZABETHTOWN, KY 42701
Peer Specialist
100 PAR LN STE 102
ELIZABETHTOWN, KY 42701

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 Tony Fredericks's NPI number?

The NPI number for Tony Fredericks is 1174236624. It was assigned to this individual provider in the NPPES registry on December 29, 2022.

Where is Tony Fredericks located?

Tony Fredericks practices at 100 Par Ln Ste 102, Elizabethtown, KY 42701. The listed phone number is (270) 312-2500.

What is Tony Fredericks's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Tony Fredericks was last updated on December 29, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.