CHARLES R FREDERICKS PHD
NPI 1902312655
Psychologist - Clinical in West Long Branch, NJ

Q: What is Charles Fredericks's NPI number?

The NPI number for Charles Fredericks is 1902312655. It was assigned to this individual provider in the NPPES registry on December 18, 2017.

Q: What is Charles Fredericks's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since December 18, 2017

1049 BROADWAY STE 2, WEST LONG BRANCH, NJ 07764(732) 222-1100(732) 222-1103 Get Directions Write a Review

NPPES record last updated: December 18, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

On this page

About Charles R Fredericks Phd NPPES

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

CHARLES R FREDERICKS PHD (NPI 1902312655) is an individual clinical provider in West Long Branch, New Jersey, licensed in New Jersey (35S100267600) and active in the NPI registry since December 2017.

NPPES Registry Identity

NPI1902312655

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameCHARLES R FREDERICKSCredential: PHD

Location Address1049 BROADWAY STE 2West Long Branch, NJ 07764-1335

Mailing Address1049 Broadway Ste 2West Long Branch, NJ 07764-1335 · (732) 222-1100 · Fax (732) 222-1103

Phone(732) 222-1100

Fax(732) 222-1103

Sole ProprietorYes

Enumeration DateDecember 18, 2017

✔ NPI 1902312655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in NJ · 35S100267600

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

1049 BROADWAY STE 2, West Long Branch, NJ 07764

Open in Google Maps ↗

Other Providers at the Same Location NPPES 15

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

GWEN JANAE ZEGESTOWSKY PSYD

Psychologist (Clinical)