Provider Demographics
NPI:1598985426
Name:FREEMAN, MARLYS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARLYS
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 1:1408 N KILLIAN DR
Mailing Address - Street 2:#202
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-1962
Mailing Address - Country:US
Mailing Address - Phone:772-285-6873
Mailing Address - Fax:772-692-2389
Practice Address - Street 1:1408 N KILLIAN DR
Practice Address - Street 2:#202
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-1962
Practice Address - Country:US
Practice Address - Phone:772-285-6873
Practice Address - Fax:772-692-2389
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW34871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical