JACLYN CAROL FREDRIKSEN PH.D., LMHC, LMFT
NPI 1710654777
Counselor - Mental Health in Cherry Valley, NY
About Jaclyn Carol Fredriksen Ph.d., Lmhc, Lmft NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACLYN CAROL FREDRIKSEN PH.D., LMHC, LMFT (NPI 1710654777) is an individual mental health provider in Cherry Valley, New York, licensed in New York (012161) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jaclyn Carol Fredriksen Ph.d., Lmhc, Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jaclyn Fredriksen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Cherry Valley, NY 13320
- Reassigned Medicare billing, New York enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CHERRY VALLEY, NY 13320
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 Jaclyn Fredriksen's NPI number?
The NPI number for Jaclyn Fredriksen is 1710654777. It was assigned to this individual provider in the NPPES registry on August 26, 2021.
Where is Jaclyn Fredriksen located?
Jaclyn Fredriksen practices at 3212 County Highway 31, Cherry Valley, NY 13320. The listed phone number is (607) 677-4052.
What is Jaclyn Fredriksen's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Jaclyn Fredriksen enrolled in Medicare?
Yes. Jaclyn Fredriksen is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jaclyn Fredriksen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jaclyn Fredriksen reassigns Medicare benefits to Fredriksen Mental Health Counseling PC (Cherry Valley, NY). 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 Jaclyn Fredriksen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jaclyn Fredriksen accept?
Health plans from Oscar Health list Jaclyn Fredriksen 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 Jaclyn Fredriksen was last updated on August 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Jaclyn Carol Fredriksen, PH.D., LMHC, LMFT · NPI 1710654777
Mental Health provider in Cherry Valley, New York. Individual provider, active in the CMS NPPES registry since August 26, 2021.
## Identity
- **NPI:** 1710654777 (Entity type: Individual)
- **Enumerated:** August 26, 2021
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 012161 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 3212 COUNTY HIGHWAY 31, Cherry Valley, NY 13320-3702
- **Phone:** (607) 677-4052
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Fredriksen Mental Health Counseling PC (NPI 1396425138, Cherry Valley, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** August 1, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1710654777) · Data from the CMS NPPES public registry.