Individual
DEBORAH FREDERIKSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
124 MISSOURI AVE STE 200, KANSAS CITY, MO 64106-1499
(259) 381-6423
Mailing address
124 MISSOURI AVE STE 200, KANSAS CITY, MO 64106-1499
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2015011508
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03180
LCPC
KS
01
—
2015011508
LPC
MO
Enumeration date
02/22/2022
Last updated
06/18/2024
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