Provider Demographics
NPI:1881671600
Name:FREEMAN, REBA J (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:REBA
Middle Name:J
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:REBA
Other - Middle Name:J
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2157 N DEQUINCY ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46218-3944
Mailing Address - Country:US
Mailing Address - Phone:317-322-8838
Mailing Address - Fax:
Practice Address - Street 1:CAMP ATTERBURY
Practice Address - Street 2:BEHAVIORAL HEALTH SERVICES
Practice Address - City:EDINBURGH
Practice Address - State:IN
Practice Address - Zip Code:46124
Practice Address - Country:US
Practice Address - Phone:812-526-1785
Practice Address - Fax:812-526-1326
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004937A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical