Healthcare Provider Details

I. General information

NPI: 1235788555
Provider Name (Legal Business Name): DAVID MATTHEW FREEMAN LCSW, LCADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 NEW YORK AVE STE 2
JERSEY CITY NJ
07307-1605
US

IV. Provider business mailing address

223 NEW YORK AVE
JERSEY CITY NJ
07307-1605
US

V. Phone/Fax

Practice location:
  • Phone: 201-656-0599
  • Fax:
Mailing address:
  • Phone: 201-407-9911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00270000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05740700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: