Individual provider Active NPI

Shraga Freedman, CT

  • Counselor
  • Middletown, OH
National Provider Identifier
1265994552
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
C.1901619-TRNE Issued in OH
Practice address
4464 S Dixie Hwy
Middletown, OH 45005-5464
Phone
(513) 649-8008
NPI assigned
Apr 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C.1901619-TRNE OH Primary

Addresses

Primary practice location

4464 S Dixie Hwy
Middletown, OH 45005-5464

Mailing address

4464 S Dixie Hwy
Middletown, OH 45005-5464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20240305001564 MD Practitioner - Mental Health Counselor 6002251634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Empowerment Therapy Services of Maryland, LLCGroup PAC ID 0345644092, 19 clinicians

Practice addresses (Care Compare)

3655 A Old Court Rd
Baltimore, MD 21208-3959
Phone (410) 630-9064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1901619-TRNEOHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerment Therapy Services of Maryland, LLC CurrentSince Feb 1, 2024 Accepting new patients
Access Counseling Services LLC PastSince Nov 4, 2014 Accepting new patients
Access Counseling Services, LLC Past Accepting new patients

Locations

3655A Old Court Rd
Ste 123
Pikesville, MD 21208
Phone (410) 630-9064

3655A Old Court Rd
Pikesville, MD 21208
Phone (410) 404-0786

Organizations & group practices 3

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": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1265994552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4464 S DIXIE HWY",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450055464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4464 S DIXIE HWY",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450055464",
            "telephone_number": "513-649-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEDMAN",
        "first_name": "SHRAGA",
        "credential": "CT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-04",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.1901619-TRNE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

Verify at the official NPI Registry.