Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Rebecca Nicole Fredericks, LICSW, PMH-C

Individual provider Clinical Social Worker · NPI 1831935774

Rebecca Nicole Fredericks, LICSW, PMH-C is a Clinical Social Worker in Providence, Rhode Island. Qualified in 2020, 6 years ago. Practices with Providence Behavioral Health Associates Inc, a 19-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
6
Licensed in
RI
In the registry since
2024
What do these letters mean?
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

1075 Smith St Ste 2
Providence, RI 02908-2700
Phone: (401) 369-9224
Fax: (401) 369-9275
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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 ISW04082 (RI)

Record details

NPI number1831935774
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW , PMH-C
Sole proprietorNo
NPI enumeratedJuly 1, 2024
Last updated in NPPESAugust 7, 2024
Certification dateAugust 7, 2024

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Providence Behavioral Health Associates Inc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Providence