Individual
CASEY C FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC, LCPAT, LPC
Contact information
Practice address
8 BROOKES AVE STE 200, GAITHERSBURG, MD 20877-2799
(240) 452-0872
Mailing address
396 ASH ST, SAINT MARYS, PA 15857-1552
(814) 562-0224
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
ATC360
MD
101YM0800X
Mental Health Counselor
Primary
LC13322
MD
101YM0800X
Mental Health Counselor
PC017187
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861036436
—
MD
Enumeration date
03/01/2021
Last updated
10/17/2025
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