Brooke Leigh Fredrickson, LRD, CSG
NPI 1053645317ActiveIndividual· Dietitian, Registered· Cooperstown, ND
Dietitian, Registered (LRD, CSG) with Valley Christian Counseling Center Inc, practicing in Cooperstown, North Dakota. Enrolled in Medicare as practitioner - registered dietitian or nutrition professional.
Overview
| NPI | 1053645317 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LRD, CSG |
| Sole proprietor | No |
| NPI issued | Sep 18, 2009 |
| Last updated in NPPES | Sep 18, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | 669 | ND |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Registered Dietitian Or Nutrition Professional (ND) |
|---|
Education and affiliations
| Graduation year | 2005 |
|---|---|
| Medicare specialty | Registered Dietitian Or Nutrition Professional |
Medical group
- Valley Christian Counseling Center IncFargo, ND · 18 clinicians