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General NPI Number Information
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NPI Number | 1902674658
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Entity Type | Individual
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Provider Name | JENNIFER SUZANNE FREUD LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 1870 AMHERST ST STE 2D
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City | WINCHESTER
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State | VA
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Zip | 22601-2841
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Country | US
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Telephone | 703-407-0215
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Fax |
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Provider Business Mailing Address
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Address Line | 11260 ROGER BACON DR STE 204
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City | RESTON
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State | VA
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Zip | 20190-5252
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Country | US
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Telephone | 703-407-0215
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904016074
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License Number State | VA
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