Provider Demographics
NPI:1881984417
Name:FREEDBERG, MICHELLE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:FREEDBERG
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 1:40 GLENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:UPPER SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-2209
Mailing Address - Country:US
Mailing Address - Phone:917-716-8147
Mailing Address - Fax:
Practice Address - Street 1:136 BROADWAY
Practice Address - Street 2:SUITE 4
Practice Address - City:WOODCLIFF LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07677-8078
Practice Address - Country:US
Practice Address - Phone:917-716-8147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-16
Last Update Date:2011-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054498001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical