Individual ProviderJoanna FrederickSocial WorkerBehavioral Health & Social Service ProvidersPractice Address1055 E Baltimore Pike, Suite 306, Media, PA 19063-5173(610) 892-3800PECOS EnrollmentBased on the most recent information from CMS, provider Joanna Frederick is legally eligible to order and refer claims for DME services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1336477504Provider TypeIndividualFull NameFrederick, JoannaCredentialLCSWGenderFemaleSole ProprietorYesEnumeration Date11/30/2009Last Updated1/8/2011Contact InformationPractice LocationPractice Address1055 E Baltimore Pike, Suite 306, Media, PA 19063-5173Phone(610) 892-3800FaxUnlisted FaxMailing LocationMailing Address1055 E Baltimore Pike, Suite 306, Media, PA 19063-5173Phone(610) 892-3800FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseCW016495Pennsylvania