Healthcare Provider Details

I. General information

NPI: 1700395324
Provider Name (Legal Business Name): CINDY L. FREER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2017
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 E GARDEN AVE
OSBURN ID
83849-0750
US

IV. Provider business mailing address

PO BOX 2060
OSBURN ID
83849-2060
US

V. Phone/Fax

Practice location:
  • Phone: 208-819-5415
  • Fax: 208-203-1496
Mailing address:
  • Phone: 208-819-5415
  • Fax: 208-203-1496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-39387
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: