Provider Demographics
NPI:1336163914
Name:FREIMAN, LOWELL RAY (LCSW)
Entity Type:Individual
Prefix:
First Name:LOWELL
Middle Name:RAY
Last Name:FREIMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-2916
Mailing Address - Country:US
Mailing Address - Phone:207-594-1000
Mailing Address - Fax:207-596-5598
Practice Address - Street 1:18 MAPLE ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2916
Practice Address - Country:US
Practice Address - Phone:207-594-1000
Practice Address - Fax:207-596-5598
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC5131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM4456Medicare ID - Type Unspecified