Provider Demographics
NPI:1780204453
Name:FREEMAN, LEIGH MATTOX (LISW-CP)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:MATTOX
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 E GREENVILLE ST STE 3600
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1725
Mailing Address - Country:US
Mailing Address - Phone:864-512-1574
Mailing Address - Fax:
Practice Address - Street 1:2000 E GREENVILLE ST STE 3600
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1725
Practice Address - Country:US
Practice Address - Phone:864-512-1475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC49521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical