| Doctor Name: | ERLING L FREDRICKSON |
| NPI Number: | 1730308172 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LISW-CP |
| License Number: | 5710 |
| Business Practice Address: | 158 Grandfather Home Way, Hickory Nut Gap Rd. Banner Elk, NC - 28604 |
| Business Phone Number: | 8288986140 |
| Business Fax Number: | 8288988513 |
| Mailing Address: | Po Box 98, BANNER ELK |
| State: | NC |
| Postal Code: | 286040098 |
| Phone Number: | 8288986140 |
| Fax Number: | 8288988513 |
| NPI Enumeration Date: | 04/24/2007 |
| NPI Last Update Date: | 11/16/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 5710 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |