=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740994912
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RACHAEL FREEDMAN LMSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/11/2023
-----------------------------------------------------
Last Update Date | 11/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 223 BRIDGE ST STE E
-----------------------------------------------------
City | CHARLEVOIX
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49720-1400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-418-8252
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1738 W ROSCOE ST APT 2
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60657-7850
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-418-8252
-----------------------------------------------------
Fax | 734-228-4898
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 6801119657
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------