Provider Demographics
NPI:1275014888
Name:FREEMAN, BRANDON (LPC)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 S POPLAR ST UNIT 218
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-3607
Mailing Address - Country:US
Mailing Address - Phone:856-347-2066
Mailing Address - Fax:
Practice Address - Street 1:15 S POPLAR ST UNIT 218
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-3607
Practice Address - Country:US
Practice Address - Phone:856-347-2066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00896400101YM0800X, 101YP2500X
NJ37AC00423400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health