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JACLYN CAROL FREDRIKSEN PH.D., LMHC, LMFT
NPI 1710654777
Counselor - Mental Health in Cherry Valley, NY

Active since August 26, 2021PECOS Enrolled
3212 COUNTY HIGHWAY 31, CHERRY VALLEY, NY 13320(607) 677-4052 Get Directions Write a Review

NPPES record last updated: August 1, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 1, 2024, Aug 28, 2023, Jul 20, 2023 and 2 more (5 updates tracked since 2021).

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

NPI1710654777
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJACLYN CAROL FREDRIKSENCredential: PH.D., LMHC, LMFT
Location Address3212 COUNTY HIGHWAY 31Cherry Valley, NY 13320-3702
Mailing AddressPo Box 12Fort Plain, NY 13339-9998 · (607) 677-4052
Phone(607) 677-4052
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateAugust 26, 2021
Last NPPES UpdateAugust 1, 20245 updates tracked since enumeration
NPPES CertifiedJuly 30, 2024
✔ NPI 1710654777 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Licenses✔ Licensed in NY · 012161✔ Licensed in NY · 002156
3212 COUNTY HIGHWAY 31, Cherry Valley, NY 13320
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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).

PECOS PAC ID7214388925
PECOS Enrollment IDI20240108000228
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.

Other Providers at the Same Location NPPES

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

FREDRIKSEN MENTAL HEALTH COUNSELING PC
Counselor (Mental Health)
3212 COUNTY HIGHWAY 31
CHERRY VALLEY, NY 13320
Otsego County (607) 677-4052

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.

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.