Individual provider Active NPI

James Jackson Freeland Jr., LCSW

  • Clinical Social Worker
  • Callahan, FL
National Provider Identifier
1467464289
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3397 Issued in FL
Practice address
54086 Dornbush Rd
Callahan, FL 32011-5919
Phone
(904) 879-6264
NPI assigned
Aug 12, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3397 FL Primary
Clinical Social Worker 1041C0700X 20239 CA

Addresses

Primary practice location

54086 Dornbush Rd
Callahan, FL 32011-5919

Mailing address

54086 Dornbush Rd
Callahan, FL 32011-5919
Phone (904) 879-6264

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20150923003264 NV Practitioner - Clinical Social Worker 5991973281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Diana Wright Psy D LLCGroup PAC ID 7113263971, 18 clinicians

Practice addresses (Care Compare)

4600 Kietzke LN
Suite N250
Reno, NV 89502-5000
Phone (775) 507-7222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3397FLMDClinical Social Worker
20239CAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Diana Wright, Psy.D., LLC Clinical CurrentSince Dec 1, 2018 Accepting new patients
Sage Health Services, LLC PastSince Nov 1, 2020 Accepting new patients

Locations

4600 Kietzke Ln
Ste N250
Reno, NV 89502
Phone (775) 500-0396

Organizations & group practices 2

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467464289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54086 DORNBUSH RD",
            "city": "CALLAHAN",
            "state": "FL",
            "postal_code": "320115919",
            "telephone_number": "904-879-6264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54086 DORNBUSH RD",
            "city": "CALLAHAN",
            "state": "FL",
            "postal_code": "320115919",
            "telephone_number": "904-879-6264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREELAND",
        "first_name": "JAMES",
        "middle_name": "JACKSON",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "3397",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "20239",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Callahan, FL

Sources for this page

Verify at the official NPI Registry.