NPIMap

Isaac Gregory Freeman, BSW, MSW, LMSW, LCSW

Individual provider Active NPI Clinical Social Worker · Black, MO

NPI 1780311373 · NPPES record last updated Jan 7, 2025

Key facts

NPI
1780311373
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
2024038037 (MO)
Practice address
525 County Road 816
Black, MO 63625-9115
Phone
(573) 269-4291
Fax
(573) 269-4202
NPI assigned
Aug 3, 2022
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2024038037MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Springs Enterprises, Inc. Current
since Sep 25, 2022		 Accepting new patients
Valley Springs Youth Ranch Past
since Aug 7, 2022		 Accepting new patients

Locations

525 County Road 816
Black, MO 63625
Phone (573) 269-4291

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2024038037 MO Yes

Addresses

Primary practice location

525 County Road 816
Black, MO 63625-9115

Mailing address

525 County Road 816
Black, MO 63625-9115
Phone (573) 269-4291

Other providers in Black, MO

All providers in Black, MO · Clinical Social Worker in Missouri

Sources for this page

Verify at the official NPI Registry.