Provider Demographics
NPI:1013358860
Name:FREEMAN, CARLOS (PHD, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6105 LAROCHE RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-6058
Mailing Address - Country:US
Mailing Address - Phone:931-378-4947
Mailing Address - Fax:
Practice Address - Street 1:6105 LAROCHE RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-6058
Practice Address - Country:US
Practice Address - Phone:931-378-4947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-13-14074103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst