MEDICARE: MRS. CORRYN NICOLE FREEMAN-WELLS

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	106S00000X	Behavior Technician	161797	OH
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1356935274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CORRYN NICOLE FREEMAN-WELLS

Provider Business Mailing Address
First Line	:	4415 EUCLID AVE.
Second Line	:	STE 315
City	:	CLEVELAND
State	:	OH
Zip	:	44103
Country	:	US
Telephone Number	:	216-465-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4415 EUCLID AVE STE 315
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44103-3759
Country	:	US
Telephone Number	:	216-465-2000
Fax Number	:

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

Provider Enumeration Date	:	02/22/2021
Last Update Date	:	10/24/2025

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Directions to “ MRS. CORRYN NICOLE FREEMAN-WELLS ” Practice Location

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