Provider Demographics
NPI:1093188963
Name:FREEMAN, KELLY PEARSON (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:PEARSON
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 OLD FARM SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-9600
Mailing Address - Country:US
Mailing Address - Phone:203-313-3661
Mailing Address - Fax:
Practice Address - Street 1:10 CRISPIN CT STE 203D
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-8205
Practice Address - Country:US
Practice Address - Phone:828-250-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-02
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0098141041C0700X
NCC0112181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical