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General NPI Number Information
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NPI Number | 1003176009
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Entity Type | Organization
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Legal Business Name | MICHAEL B. FREEDMAN PHD
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Dates
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Enumeration Date | 05/23/2012
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Last Update Date | 05/23/2012
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Provider Practice Location Address
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Address Line | 6006 PARK HEIGHTS AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-3643
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Country | US
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Telephone | 410-790-8433
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Fax | 443-501-3379
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Provider Business Mailing Address
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Address Line | 6006 PARK HEIGHTS AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-3643
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Country | US
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Telephone | 410-790-8433
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Fax | 443-501-3379
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL B FREEDMAN
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Credential | PHD
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Telephone | 410-790-8433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 11208
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11208
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License Number State | MD
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