Active NPI
Jake Freishtat
- Counselor
- Atlanta, GA
National Provider Identifier
1609485069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- MSW011282
- Practice address
- 4549 Chamblee Dunwoody Rd
Atlanta, GA 30338-6210 - Phone
- (770) 677-9341
- NPI assigned
- Jul 30, 2020
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | MSW011282 | GA | Primary |
Addresses
Primary practice location
4549 Chamblee Dunwoody Rd
Atlanta, GA 30338-6210
Mailing address
306 N Kensington Ave
La Grange Park, IL 60526-1870
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MSW011282 | GA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690329600000",
"number": "1609485069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 N KENSINGTON AVE",
"city": "LA GRANGE PARK",
"state": "IL",
"postal_code": "605261870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4549 CHAMBLEE DUNWOODY RD",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303386210",
"telephone_number": "770-677-9341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREISHTAT",
"first_name": "JAKE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-30",
"last_updated": "2023-07-26",
"certification_date": "2023-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "GA",
"license": "MSW011282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.