Provider Demographics
NPI:1629271721
Name:FREEMAN, DONNA BETH (LICSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:BETH
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-4205
Mailing Address - Country:US
Mailing Address - Phone:401-783-2952
Mailing Address - Fax:
Practice Address - Street 1:24 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-3144
Practice Address - Country:US
Practice Address - Phone:401-849-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI1SW0003241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1629271721OtherBLUE CROSS BLUE SHIELD