Provider Demographics
NPI:1467920504
Name:FREEMAN-HARDING, RIVKAH IMELDA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RIVKAH
Middle Name:IMELDA
Last Name:FREEMAN-HARDING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:RIVKAH
Other - Middle Name:IMELDA
Other - Last Name:FREEMAN-DASENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1439 MINGARY AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-7809
Mailing Address - Country:US
Mailing Address - Phone:860-833-9249
Mailing Address - Fax:
Practice Address - Street 1:4600 SWAMP FOX HWY W
Practice Address - Street 2:
Practice Address - City:TABOR CITY
Practice Address - State:NC
Practice Address - Zip Code:28463-8667
Practice Address - Country:US
Practice Address - Phone:910-653-6413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0108321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical