Provider Demographics
NPI:1558969485
Name:FREEBURG, CHRISTINE LUISE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LUISE
Last Name:FREEBURG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4825 ALLIANCE BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5504
Mailing Address - Country:US
Mailing Address - Phone:469-250-8007
Mailing Address - Fax:281-648-2200
Practice Address - Street 1:4825 ALLIANCE BLVD STE 150
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5504
Practice Address - Country:US
Practice Address - Phone:469-250-8007
Practice Address - Fax:281-648-2200
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX298181041C0700X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical