Melissa Anne Freeman, MSW LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6548123 Issued in WI

Practice address

2500 Hall Ave
Suite a Marinette County Health and Human Services
Marniette, WI 54143

Phone

(715) 732-7760

Fax

(715) 732-7711

NPI assigned

Oct 12, 2006

Last updated

Feb 12, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1831288174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 HALL AVE",
            "address_2": "SUITE A MARINETTE COUNTY HEALTH AND HUMAN SERVICES",
            "city": "MARNIETTE",
            "state": "WI",
            "postal_code": "54143",
            "telephone_number": "715-732-7760",
            "fax_number": "715-732-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HALL AVE",
            "address_2": "SUITE A MARINETTE COUNTY HEALTH AND HUMAN SERVICES",
            "city": "MARNIETTE",
            "state": "WI",
            "postal_code": "54143",
            "telephone_number": "715-732-7760",
            "fax_number": "715-732-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "6548123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6548123",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39778800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Jean Jacobson, MS

• Clinical Social Worker in Marniette, WI
• Providers in Marniette, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.