Individual provider Active NPI

Andrew M Freedman

  • Counselor
  • Philadelphia, PA
National Provider Identifier
1740941194
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
PC013734 Issued in PA
Practice address
4508 Blakiston St
Philadelphia, PA 19136-2405
Phone
(202) 285-1988
NPI assigned
Jan 7, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X PC013734 PA Primary

Addresses

Primary practice location

4508 Blakiston St
Philadelphia, PA 19136-2405

Mailing address

2618 E Dauphin St
Philadelphia, PA 19125-3621
Phone (202) 285-1988

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

LicenseStateTypeSpecialty
PC013734PAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1740941194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2618 E DAUPHIN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191253621",
            "telephone_number": "202-285-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4508 BLAKISTON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191362405",
            "telephone_number": "202-285-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEDMAN",
        "first_name": "ANDREW",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "PA",
            "license": "PC013734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.