Healthcare Provider Details

I. General information

NPI: 1336696442
Provider Name (Legal Business Name): CHELSEA ALISE FREEMAN LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2016
Last Update Date: 09/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 E. STREET
LORAIN OH
44052-2106
US

IV. Provider business mailing address

25174 SPRAGUE RD
OLMSTED FALLS OH
44138-2868
US

V. Phone/Fax

Practice location:
  • Phone: 440-288-0448
  • Fax:
Mailing address:
  • Phone: 440-288-0448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberS.1600351
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: