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

Mr. Timothy Fredrickson, LCPC

Individual provider Professional Counselor · NPI 1922073642

Mr. Timothy Fredrickson, LCPC is a Mental Health Counselor in Rockford, Illinois. Qualified in 1991, 35 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
35
Licensed in
IL
In the registry since
2006
What do these letters mean?
LCPC — Licensed Clinical Professional Counselor
A licensed clinical counsellor.

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Practice location Address checks out

1639 N Alpine Rd Ste 403
Rockford, IL 61107-1440
Phone: (815) 229-7102
Fax: (815) 229-7108
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 180-001837 (IL)

Record details

NPI number1922073642
Entity typeIndividual (Type 1)
GenderMale
Credentials LCPC
Sole proprietorYes
NPI enumeratedFebruary 17, 2006
Last updated in NPPESNovember 6, 2023
Certification dateMay 10, 2021
Mailing address1639 N Alpine Rd Ste 403, Rockford, IL 61107-1440

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 1991 (35 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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