Provider Demographics
NPI:1891099867
Name:FREEMAN, KATHERINE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
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 1:2109 N PATTERSON ST
Mailing Address - Street 2:STE B
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2577
Mailing Address - Country:US
Mailing Address - Phone:229-469-7019
Mailing Address - Fax:877-992-0331
Practice Address - Street 1:2109 N PATTERSON ST STE B
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2577
Practice Address - Country:US
Practice Address - Phone:229-232-4833
Practice Address - Fax:877-343-0538
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0050911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1013321397OtherBLUE CROSS BLUE SHIELD/ANTHEM