Provider Demographics
NPI:1205159902
Name:FREED, JAMILLE (LICSW)
Entity type:Individual
Prefix:
First Name:JAMILLE
Middle Name:
Last Name:FREED
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 1:32 ORRIS ST
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02466-1312
Mailing Address - Country:US
Mailing Address - Phone:617-596-3281
Mailing Address - Fax:
Practice Address - Street 1:572 WASHINGTON ST
Practice Address - Street 2:SUITE 14
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-6418
Practice Address - Country:US
Practice Address - Phone:617-596-3281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1110841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical