Provider Demographics
NPI:1093936742
Name:FREED, JUDY P (MSW)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:P
Last Name:FREED
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BELMONT CENTER
Mailing Address - Street 2:4200 MONUMENT ROAD
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131
Mailing Address - Country:US
Mailing Address - Phone:215-581-9142
Mailing Address - Fax:215-581-3827
Practice Address - Street 1:BELMONT CENTER
Practice Address - Street 2:4200 MONUMENT ROAD
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131
Practice Address - Country:US
Practice Address - Phone:215-581-9142
Practice Address - Fax:215-581-3827
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0156571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical