MEDICARE: MRS. EMILY EARL 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	C006566	NC

General Provider Information

NPI Number	:	1528332749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMILY EARL FREEMAN LCSW

Provider Business Mailing Address
First Line	:	1601 JONES FRANKLIN RD
Second Line	:	SUITE 104
City	:	RALEIGH
State	:	NC
Zip	:	27606-3379
Country	:	US
Telephone Number	:	919-851-1527
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 JONES FRANKLIN RD
Second Line	:	SUITE 104
City	:	RALEIGH
State	:	NC
Zip	:	27606-3379
Country	:	US
Telephone Number	:	919-851-1527
Fax Number	:

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

Provider Enumeration Date	:	03/06/2012
Last Update Date	:	10/09/2013

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