Provider Demographics
NPI:1265507842
Name:FREEMAN, SHELLEY CECILE (PHD, LMHP)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:CECILE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PHD, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7441 O ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2468
Mailing Address - Country:US
Mailing Address - Phone:402-483-4215
Mailing Address - Fax:402-483-5228
Practice Address - Street 1:7441 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2468
Practice Address - Country:US
Practice Address - Phone:402-483-4215
Practice Address - Fax:402-483-5228
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3473101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE456304000OtherMAGELLAN MIS PLAZA SITE
NE470756369-26Medicaid
NE47075636926Medicaid
NE47075636926Medicaid