Provider Demographics
NPI:1881685402
Name:FREIT, KATHRYN THOMPSON (LCSW)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:THOMPSON
Last Name:FREIT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LESLIE DR
Mailing Address - Street 2:STE 917
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-7311
Mailing Address - Country:US
Mailing Address - Phone:954-830-9544
Mailing Address - Fax:
Practice Address - Street 1:200 LESLIE DR
Practice Address - Street 2:STE 917
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-7311
Practice Address - Country:US
Practice Address - Phone:954-830-9544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052554001041C0700X
FLSW 109871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11566298OtherCAQH
FL811457194OtherUNITED BEHAVIORAL HEALTH