Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mallory Logan Frederick, BS, CDCA

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1477917748

Mallory Logan Frederick, BS, CDCA is an Addiction (Substance Use Disorder) Counselor in Reynoldsburg, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2016
Specialties on file
2
What do these letters mean?
BS — Bachelor of Science
An undergraduate science degree.

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Practice location Address checks out

6434 E Main St 201
Reynoldsburg, OH 43068
Phone: (614) 762-2847
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 150835 (OH)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X

Record details

NPI number1477917748
Entity typeIndividual (Type 1)
GenderFemale
Credentials BS , CDCA
Sole proprietorYes
NPI enumeratedApril 12, 2016
Last updated in NPPESMarch 29, 2017
Mailing address6434 E Main St, 201, Reynoldsburg, OH 43068-7300

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