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General NPI Number Information
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NPI Number | 1265821615
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Entity Type | Organization
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Legal Business Name | FREEDMAN MENTAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 01/22/2015
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 60 AUSTIN ST STE 101
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City | NEWTONVILLE
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State | MA
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Zip | 02460-1857
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Country | US
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Telephone | 617-735-7044
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Fax |
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Provider Business Mailing Address
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Address Line | 64 RIDGE AVE
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City | NEWTON CENTRE
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State | MA
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Zip | 02459-2535
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Country | US
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Telephone | 617-735-7044
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN S FREEDMAN
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Credential | RN CNS
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Telephone | 617-735-7044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | MA114131
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License Number State | MA
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