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NPI Code Detail

MEDICARE: JENNIFER SMITH FREER LCSW

MEDICARE: JENNIFER SMITH FREER 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
1104100000XSocial WorkerC-09135NM
2104100000XSocial Worker3992-CAR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942236328
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER SMITH FREER LCSW
Provider Business Mailing Address
First Line : 6001 WHITEMAN DR NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87120-2196
Country : US
Telephone Number : 505-717-1155
Fax Number :
Provider Business Practice Location Address
First Line : 6001 WHITEMAN DR NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87120-2196
Country : US
Telephone Number : 505-717-1155
Fax Number : 505-717-1473
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2006
Last Update Date : 12/13/2024

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Directions to “ JENNIFER SMITH FREER LCSW” Practice Location

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