Healthcare Provider Details

I. General information

NPI: 1316853930
Provider Name (Legal Business Name): MR. EDWIN Z FREEMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8187 TELEGRAPH RD
SEVERN MD
21144-3205
US

IV. Provider business mailing address

1706A SEVERN RD
SEVERN MD
21144-1001
US

V. Phone/Fax

Practice location:
  • Phone: 828-291-2634
  • Fax:
Mailing address:
  • Phone: 828-291-2634
  • Fax: 878-772-0504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP18383
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberLGP18383
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLGP18383
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberLGP18383
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP18383
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: