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General NPI Number Information
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NPI Number | 1164677688
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Entity Type | Individual
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Provider Name | AMY LYNN FREEMAN CAGS, LMHC
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Gender | Female
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Dates
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Enumeration Date | 11/25/2008
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Last Update Date | 10/13/2019
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Provider Practice Location Address
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Address Line | 100 GROVE ST STE 306
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City | WORCESTER
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State | MA
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Zip | 01605-2647
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Country | US
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Telephone | 774-262-0703
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Fax |
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Provider Business Mailing Address
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Address Line | 32 ASSABET LN
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City | WORCESTER
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State | MA
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Zip | 01602
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Country | US
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Telephone | 774-262-0703
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11457
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License Number State | MA
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