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

Raymond Gene Fredrickson, MSW, LICSW, SUDPT

Individual provider Clinical Social Worker · NPI 1902495351

Raymond Gene Fredrickson, MSW, LICSW, SUDPT is a Clinical Social Worker in Spokane, Washington. Qualified in 2016, 10 years ago. Practices with Mental Health Specialty Group PA, a 679-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
10
Licensed in
WA
In the registry since
2021
Specialties on file
2
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

104 S Freya St
Spokane, WA 99202-4862
Phone: (509) 964-1590
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LW61238408 (WA)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence CO61137490 (WA)

Record details

NPI number1902495351
Entity typeIndividual (Type 1)
GenderMale
Credentials MSW , LICSW , SUDPT
Sole proprietorNo
NPI enumeratedJanuary 11, 2021
Last updated in NPPESSeptember 8, 2025
Certification dateSeptember 8, 2025

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Mental Health Specialty Group Pa — 679 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Spokane