Provider Demographics
NPI:1932707270
Name:FREEMAN, STEPHANIE EVERETTE (LCSW, LCAS)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:EVERETTE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6431 TURKEY CHASE RD
Mailing Address - Street 2:
Mailing Address - City:BATTLEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27809-9620
Mailing Address - Country:US
Mailing Address - Phone:252-548-1203
Mailing Address - Fax:
Practice Address - Street 1:6431 TURKEY CHASE RD
Practice Address - Street 2:
Practice Address - City:BATTLEBORO
Practice Address - State:NC
Practice Address - Zip Code:27809-9620
Practice Address - Country:US
Practice Address - Phone:252-548-1203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-21392101YA0400X
NCC0111961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)