Provider Demographics
NPI:1568568053
Name:FREEMAN, MARGARETA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARGARETA
Middle Name:
Last Name:FREEMAN
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 1:356 REDMOND RD
Mailing Address - Street 2:
Mailing Address - City:S ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1505
Mailing Address - Country:US
Mailing Address - Phone:973-761-4420
Mailing Address - Fax:973-761-4424
Practice Address - Street 1:2115 MILLBURN AVE
Practice Address - Street 2:SUITE #100-1
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3714
Practice Address - Country:US
Practice Address - Phone:973-761-4420
Practice Address - Fax:973-761-4424
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC04716300103T00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ056890Medicare ID - Type Unspecified