Provider Demographics
NPI:1104998178
Name:FREEDMAN, NORINE (MA , LCPC)
Entity type:Individual
Prefix:
First Name:NORINE
Middle Name:
Last Name:FREEDMAN
Suffix:
Gender:F
Credentials:MA , LCPC
Other - Prefix:
Other - First Name:NICKY
Other - Middle Name:
Other - Last Name:FREEDMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA , LCPC
Mailing Address - Street 1:929 FOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4860
Mailing Address - Country:US
Mailing Address - Phone:847-267-8282
Mailing Address - Fax:847-267-8383
Practice Address - Street 1:929 FOUNTAIN VIEW DR
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4860
Practice Address - Country:US
Practice Address - Phone:847-291-1900
Practice Address - Fax:847-267-8383
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2008-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-001653101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001622485OtherBCBSIL