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

Mr. Gary J Fredericksen, LICSW

Individual provider Mental Health Counselor · NPI 1700950557

Mr. Gary J Fredericksen, LICSW is a Mental Health Counselor in Lacey, Washington. Practices as a sole proprietor. Licensed in Washington.

Licensed in
WA
In the registry since
2006
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

See every abbreviation used in this directory →

Practice location Address checks out

4422 6th Ave SE
Lacey, WA 98503-1020
Phone: (360) 704-7170
Fax: (360) 412-4982
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LW00004165 (WA)
Mental Health Counselor Taxonomy 101YM0800X · Licence LW00004165 (WA)

Record details

NPI number1700950557
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorYes
NPI enumeratedNovember 20, 2006
Last updated in NPPESJuly 20, 2007

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