Active NPI
Joe L Freeman, LCSW
- Mental Health Counselor
- Tolland, CT
National Provider Identifier
1245393909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LCSW 004864
- 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, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW 004864 | CT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.