Provider Demographics
NPI:1215345533
Name:FREIBERG, RACHEL LEON (LMHC)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:LEON
Last Name:FREIBERG
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13327 FERNOW ST
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-6378
Mailing Address - Country:US
Mailing Address - Phone:954-610-9793
Mailing Address - Fax:
Practice Address - Street 1:13327 FERNOW ST
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-6378
Practice Address - Country:US
Practice Address - Phone:954-610-9793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-30
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6248101YM0800X
FL16625101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD3645Medicaid