Provider Demographics
NPI:1902849672
Name:FREITAS, LYNN G (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:G
Last Name:FREITAS
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 1:309 S SHARON AMITY RD STE 304
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-2886
Mailing Address - Country:US
Mailing Address - Phone:704-998-0221
Mailing Address - Fax:704-366-6464
Practice Address - Street 1:309 S SHARON AMITY RD STE 304
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-2886
Practice Address - Country:US
Practice Address - Phone:704-998-0221
Practice Address - Fax:704-366-6464
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YA0400X, 106H00000X
NCC0030751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC11112OtherBLUECROSS BLUESHIELDOFNC