Provider Demographics
NPI:1467920504
Name:FREEMAN-DASENT, RIVKAH IMELDA (LCSW)
Entity type:Individual
Prefix:MS
First Name:RIVKAH
Middle Name:IMELDA
Last Name:FREEMAN-DASENT
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:MS
Other - First Name:RIVKAH
Other - Middle Name:IMELDA
Other - Last Name:FREEMAN-HARDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2817 ROCK MERRITT RD FAMILY ADVOCACY PROGRAM
Mailing Address - Street 2:
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310-0001
Mailing Address - Country:US
Mailing Address - Phone:860-833-9249
Mailing Address - Fax:
Practice Address - Street 1:2817 ROCK MERRITT RD ATTENTION: FAMILY ADVOCACY PROGRAM
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-8667
Practice Address - Country:US
Practice Address - Phone:910-907-6769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0108321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical