Individual provider Active NPI

Andrew Jacob Freeman, LCSW, CSAC

  • Clinical Social Worker
  • Brookfield, WI
National Provider Identifier
1710309059
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8678-123 Issued in WI
Practice address
17100 W North Ave
Brookfield, WI 53005-4436
Phone
(262) 244-6177
NPI assigned
Jan 6, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 17043-130 WI
Addiction (Substance Use Disorder) Counselor 101YA0400X 16116-132 WI
Clinical Social Worker 1041C0700X 8678-123 WI Primary

Addresses

Primary practice location

17100 W North Ave
Brookfield, WI 53005-4436

Mailing address

1035 W Glen Oaks LN Ste 110
Mequon, WI 53092-3392
Phone (262) 244-6177

Other practice location 1

N67W24937 Stonegate Ct Apt 104
Sussex, WI 53089-2586
Phone (262) 894-6277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16116-132WIMDAddiction (Substance Use Disorder) Counselor
17043-130WIMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Counseling Services, Inc Addiction (Substance Use Disorder) CurrentSince Mar 1, 2023 Accepting new patients

Locations

16535 W Bluemound Rd
Ste 200
Brookfield, WI 53005
Phone (262) 789-0909

17100 W North Ave
Ste 300
Brookfield, WI 53005
Phone (262) 244-6177

1035 W Glen Oaks Ln
Ste 110
Mequon, WI 53092
Phone (262) 240-0299

10850 W Park Pl
Ste 100
Milwaukee, WI 53224
Phone (414) 361-4100

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1388966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1710309059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 W GLEN OAKS LN STE 110",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923392",
            "telephone_number": "262-244-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 W NORTH AVE",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054436",
            "telephone_number": "262-244-6177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N67W24937 Stonegate Ct Apt 104",
            "address_purpose": "LOCATION",
            "city": "Sussex",
            "state": "WI",
            "postal_code": "530892586",
            "country_code": "US",
            "telephone_number": "262-894-6277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "ANDREW",
        "middle_name": "JACOB",
        "name_prefix": "Mr.",
        "credential": "LCSW, CSAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-06",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17043-130",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16116-132",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8678-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.