Leroy Freeman Jr., LLBSW
Individual provider Active NPI Social Worker · Bangor, MI
NPI 1609210400 · NPPES record last updated Apr 23, 2013
Key facts
- NPI
- 1609210400
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 6802087063 (MI)
- Practice address
- 32001 County Road 687
Bangor, MI 49013-9476 - Phone
- (269) 377-8400
- NPI assigned
- Apr 23, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6802087063 | MI | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802087063 | MI | Yes |
Addresses
Primary practice location
32001 County Road 687
Bangor, MI 49013-9476
Mailing address
32001 County Road 687
Bangor, MI 49013-9476
Phone (269) 377-8400
Other providers in Bangor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.