Provider Demographics
NPI:1245298561
Name:FREASIER, GEORGANN R (LCSW)
Entity type:Individual
Prefix:MS
First Name:GEORGANN
Middle Name:R
Last Name:FREASIER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1024 N ARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-6302
Mailing Address - Country:US
Mailing Address - Phone:501-661-1633
Mailing Address - Fax:501-280-0204
Practice Address - Street 1:124 N FILLMORE ST
Practice Address - Street 2:FILLMORE PLACE
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3322
Practice Address - Country:US
Practice Address - Phone:501-661-1557
Practice Address - Fax:501-661-1654
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR548-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR37814937OtherUNITED BAHAVORIAL HEALTH
AR4499093OtherAETNA
AR170718OtherVALUE OPTIONS
AR5S909Medicare UPIN