Healthcare Provider Details

I. General information

NPI: 1841194719
Provider Name (Legal Business Name): AMBER LEE FREDA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2032 MAPLE STREET
CARROLLTON GA
30117
US

IV. Provider business mailing address

250 CEDAR HEIGHTS RD LOT 89
CARROLLTON GA
30116-6348
US

V. Phone/Fax

Practice location:
  • Phone: 470-243-4742
  • Fax:
Mailing address:
  • Phone: 470-255-6278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMSW013533
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMSW013533
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: