Active NPI
Daniel B Freedman, LCSW
- Clinical Social Worker
- Charlotte, NC
National Provider Identifier
1639238108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C004971
- Practice address
- Behavioral Health Center CMC Randolph
501 Billingsley Road
Charlotte, NC 28211-1009 - Phone
- (704) 358-2700
- Fax
- (704) 358-2716
- NPI assigned
- Dec 8, 2006
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C004971 | NC | Primary |
Addresses
Primary practice location
Behavioral Health Center CMC Randolph
501 Billingsley Road
Charlotte, NC 28211-1009
Mailing address
Behavioral Health Center CMC Randolph
501 Billingsley Road
Charlotte, NC 28211-1009
Phone (704) 358-2710
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1393H | Other | NC | BCBS |
| 184358 | Other | NC | MEDCOST |
| 6003492 | Medicaid | NC |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C004971 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251244800000",
"number": "1639238108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BEHAVIORAL HEALTH CENTER CMC RANDOLPH",
"address_2": "501 BILLINGSLEY ROAD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111009",
"telephone_number": "704-358-2710",
"fax_number": "704-358-2938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BEHAVIORAL HEALTH CENTER CMC RANDOLPH",
"address_2": "501 BILLINGSLEY ROAD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111009",
"telephone_number": "704-358-2700",
"fax_number": "704-358-2716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEDMAN",
"first_name": "DANIEL",
"middle_name": "B",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-08",
"last_updated": "2009-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C004971",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1393H",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "184358",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6003492",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.