Provider Demographics
NPI:1437393220
Name:FREEMAN, REBEKKA LEE (PSYD,LADC,CCCOND)
Entity Type:Individual
Prefix:DR
First Name:REBEKKA
Middle Name:LEE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PSYD,LADC,CCCOND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0284
Mailing Address - Country:US
Mailing Address - Phone:207-338-6055
Mailing Address - Fax:
Practice Address - Street 1:37 EAST TROUT LN
Practice Address - Street 2:
Practice Address - City:SWANVILLE
Practice Address - State:ME
Practice Address - Zip Code:04915-0284
Practice Address - Country:US
Practice Address - Phone:207-338-6055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC956101YA0400X
MEXL3225101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME245720099Medicaid
ME098185OtherANTHEM BCBS