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NPI Code Detail

MEDICARE: MARY MEGAN FREEMAN LCSW

MEDICARE: MARY MEGAN FREEMAN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerC010843NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104205970
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY MEGAN FREEMAN LCSW
Provider Business Mailing Address
First Line : 2817 ROCK MERRITT AVE BLDG 4-3219
Second Line :
City : FORT BRAGG
State : NC
Zip : 28310-0001
Country : US
Telephone Number : 910-907-6999
Fax Number : 910-570-3048
Provider Business Practice Location Address
First Line : 2817 ROCK MERRITT AVE BLDG 4-3219
Second Line :
City : FORT BRAGG
State : NC
Zip : 28310-0001
Country : US
Telephone Number : 910-907-6999
Fax Number : 910-570-3048
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2015
Last Update Date : 05/08/2025

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Directions to “ MARY MEGAN FREEMAN LCSW” Practice Location

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