Individual provider Active NPI

Joe L Freeman, LCSW

  • Mental Health Counselor
  • Tolland, CT
National Provider Identifier
1245393909
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCSW 004864 Issued in CT
Practice address
384 Merrow Rd Ste D
Tolland, CT 06084-3957
Phone
(860) 875-2578
Fax
(860) 875-9963
NPI assigned
Dec 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCSW 004864 CT Primary

Addresses

Primary practice location

384 Merrow Rd Ste D
Tolland, CT 06084-3957

Mailing address

196 Davis Rd
Storrs Mansfield, CT 06268-2507
Phone (860) 429-4477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • 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
I20111012000515 CT Practitioner - Clinical Social Worker 1254503691 Practice locations: Storrs Mansfield, CT; Coventry, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

196 Davis Rd
Storrs Mansfield, CT 06268-2507
Phone (860) 634-3405

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 004864CTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Robin Rosen Mental Health Past Accepting new patients

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": "1166313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245393909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 DAVIS RD",
            "city": "STORRS MANSFIELD",
            "state": "CT",
            "postal_code": "062682507",
            "telephone_number": "860-429-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 MERROW RD STE D",
            "city": "TOLLAND",
            "state": "CT",
            "postal_code": "060843957",
            "telephone_number": "860-875-2578",
            "fax_number": "860-875-9963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "JOE",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "LCSW 004864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tolland, CT

Sources for this page

Verify at the official NPI Registry.