Provider Demographics
NPI:1508959867
Name:FREEDMAN, ELAINE DOROTHY (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:DOROTHY
Last Name:FREEDMAN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BOBOLINK RD
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-3537
Mailing Address - Country:US
Mailing Address - Phone:781-235-7990
Mailing Address - Fax:781-235-3151
Practice Address - Street 1:20 BOBOLINK RD
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-3537
Practice Address - Country:US
Practice Address - Phone:781-235-7990
Practice Address - Fax:781-235-3151
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1009331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA682896OtherTUFTS ASSOCIATED HEALTH
MA2189454OtherCIGNA INSURANCE COMPANY
MA356767OtherMAGELLAN
MAP01276OtherBLUE CROSS/BLUE SHIELD
MAP01276OtherBLUE CROSS/BLUE SHIELD