Individual provider Active NPI

Erica Marie Freeman, LCSW

  • Clinical Social Worker
  • Watertown, NY
National Provider Identifier
1013241942
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
080320 Issued in NY
Practice address
238 Arsenal St
Watertown, NY 13601-2504
Phone
(315) 782-9450
NPI assigned
Sep 24, 2009
Last updated
Mar 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 079923 NY
Clinical Social Worker 1041C0700X 080320 NY Primary

Addresses

Primary practice location

238 Arsenal St
Watertown, NY 13601-2504

Mailing address

238 Arsenal St
Watertown, NY 13601-2504
Phone (315) 782-9450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140407002080 NY Practitioner - Clinical Social Worker 0941432819 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
079923NYMDClinical Social Worker
080320NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rubenzahl, Knudsen & Associates Psych., Srvcs, P.C. CurrentSince Dec 1, 2022 Accepting new patients

Locations

22670 Summit Dr
Ste 2
Watertown, NY 13601
Phone (315) 772-3332

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1013241942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 ARSENAL ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012504",
            "telephone_number": "315-782-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 ARSENAL ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012504",
            "telephone_number": "315-782-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "ERICA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-24",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079923",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "080320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.