1114846698 NPI number — DENISE FREDETTE LCSW PLLC

Table of content: (NPI 1114846698)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114846698 NPI number — DENISE FREDETTE LCSW PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DENISE FREDETTE LCSW PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114846698
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/10/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
114 MORNINGSIDE DR APT 45
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10027-6036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-298-7950
Provider Business Mailing Address Fax Number:
929-290-0328

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
114 MORNINGSIDE DR APT 45
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10027-6036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-298-7950
Provider Business Practice Location Address Fax Number:
929-290-0328
Provider Enumeration Date:
07/10/2026

Additional Information

Authorized Official

Authorized Official Last Name:
FREDETTE
Authorized Official First Name:
DENISE
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINICAL SOCIAL WORKER
Authorized Official Telephone Number:
646-298-7950

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 07517715 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com