Provider Demographics
NPI:1912482753
Name:FREEMYER, KATIE MAE (LCSW)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:MAE
Last Name:FREEMYER
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 1:1024 S 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-1904
Mailing Address - Country:US
Mailing Address - Phone:712-441-2786
Mailing Address - Fax:
Practice Address - Street 1:3720 FLORENCE BLVD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68110-1737
Practice Address - Country:US
Practice Address - Phone:531-299-7386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17031041S0200X
NE49761041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool