Provider Demographics
NPI:1649923822
Name:FREED, GREGORY NEAL (LCSW)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:NEAL
Last Name:FREED
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 1:181 VERNON TER APT 4
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4235
Mailing Address - Country:US
Mailing Address - Phone:646-756-9669
Mailing Address - Fax:
Practice Address - Street 1:181 VERNON TER APT 4
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-4235
Practice Address - Country:US
Practice Address - Phone:646-756-9669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1050221041C0700X
CA969771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical