IndividualActive
Mick Fredrickson, LCSW
NPI 1104180520 · Clinical Social Worker · Albany, OR
Provider details
- NPI number
- 1104180520
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- Yes
- License
- L6743 (OR)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
425 2nd Ave Sw Ste 102
Albany, OR 97321-2483
Phone: (541) 286-3209
Fax: (541) 704-0040
Street-level locationGet directions
Mailing address
425 2nd Ave Sw Ste 102
Albany, OR 97321-2483
Additional practice locations (1)
- 425 2nd Ave Sw Ste 101dAlbany, OR 97321-2483Phone: (541) 220-8223Fax: (541) 833-0419
Registry dates
- Enumerated
- 2012-06-29
- Last updated
- 2021-04-14
- Certified
- 2021-04-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.