Healthcare Provider Details

I. General information

NPI: 1164344388
Provider Name (Legal Business Name): SANDRA FREEMAN CADC, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 W BONANZA RD
LAS VEGAS NV
89106-3227
US

IV. Provider business mailing address

480 W BONANZA RD
LAS VEGAS NV
89106-3227
US

V. Phone/Fax

Practice location:
  • Phone: 702-320-2084
  • Fax:
Mailing address:
  • Phone: 702-320-2084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number07687-C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: