Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mick Fredrickson, LCSW

Individual provider Clinical Social Worker · NPI 1104180520

Mick Fredrickson, LCSW is a Clinical Social Worker in Albany, Oregon. Qualified in 2005, 21 years ago. Practices with Reclaim Life LLC, a 7-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
21
Licensed in
OR
In the registry since
2012
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

425 2nd Ave SW Ste 102
Albany, OR 97321-2483
Phone: (541) 286-3209
Fax: (541) 704-0040
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 425 2nd Ave Sw Ste 101d, Albany, OR 97321-2483 — (541) 220-8223

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence L6743 (OR)

Record details

NPI number1104180520
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedJune 29, 2012
Last updated in NPPESApril 14, 2021
Certification dateApril 14, 2021
Mailing address425 2nd Ave Sw Ste 102, Albany, OR 97321-2483

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Reclaim Life Llc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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