Nicole Freeberg

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL61195420 Issued in WA

Practice address

2320 Borst Ave
Centralia, WA 98531-1410

Phone

(360) 330-7600

NPI assigned

Sep 24, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Centralia School District #401

  • Local Education Agency (LEA)
  • Centralia, WA
  • NPI 1750310405
  NPD (past)

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1336810704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 22ND ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 BORST AVE",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311410",
            "telephone_number": "360-330-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEBERG",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-24",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA19220",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL61195420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Fountain, PA-C
• Monica Fouts, OTR/L
• Olivia Lynne Foy
• Kiara Franco
• Alexa Franks
• Chad Fujiyoshi, PT
• Rachael Celia Fulginiti
• Leslie Ann Fulp, LICSWA
• Sharon C Furrer, MS, RD, CD,CDE
• Richard James Gadd, DDS

• Speech-Language Pathologist in Centralia, WA
• Providers in Centralia, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.