MEDICARE: MARY MEGAN FREEMAN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C010843	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104205970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY MEGAN FREEMAN LCSW

Provider Business Mailing Address
First Line	:	2817 ROCK MERRITT AVE BLDG 4-3219
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	910-907-6999
Fax Number	:	910-570-3048

Provider Business Practice Location Address
First Line	:	2817 ROCK MERRITT AVE BLDG 4-3219
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	910-907-6999
Fax Number	:	910-570-3048

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2015
Last Update Date	:	05/08/2025

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Directions to “ MARY MEGAN FREEMAN LCSW” Practice Location

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