MR. TIMOTHY FREDRICKSON LCPC
NPI 1922073642
Counselor - Professional in Rockford, IL

Q: What is Timothy Fredrickson's NPI number?

The NPI number for Timothy Fredrickson is 1922073642. It was assigned to this individual provider in the NPPES registry on February 17, 2006.

Q: What is Timothy Fredrickson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Active since February 17, 2006PECOS EnrolledAccepts Medicare Assignment

1639 N ALPINE RD STE 403, ROCKFORD, IL 61107(815) 229-7102(815) 229-7108 Get Directions Write a Review

NPPES record last updated: November 6, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Timothy Fredrickson Lcpc NPPES

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

MR. TIMOTHY FREDRICKSON LCPC (NPI 1922073642) is an individual professional provider in Rockford, Illinois, licensed in Illinois (180-001837) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1991).

NPPES Registry Identity

NPI1922073642

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameMR. TIMOTHY FREDRICKSONCredential: LCPC

Location Address1639 N ALPINE RD STE 403Rockford, IL 61107-1440

Mailing Address1639 N Alpine Rd Ste 403Rockford, IL 61107-1440 · (815) 229-7102 · Fax (815) 229-7108

Phone(815) 229-7102

Fax(815) 229-7108

Sole ProprietorYes

Medical School CMSOtherGraduated 1991

Enumeration DateFebruary 17, 2006

Last NPPES UpdateNovember 6, 2023

NPPES CertifiedMay 10, 2021

✔ NPI 1922073642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in IL · 180-001837

1639 N ALPINE RD STE 403, Rockford, IL 61107

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan, Quartz.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Timothy Fredrickson Lcpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3678911179

PECOS Enrollment IDI20240403001488

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 10

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

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