Provider Demographics
NPI:1285861765
Name:FREEMAN, ELLEN CECELIA (MSW)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:CECELIA
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2744 KEATING ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-1512
Mailing Address - Country:US
Mailing Address - Phone:301-423-2958
Mailing Address - Fax:
Practice Address - Street 1:411 OAK ST.
Practice Address - Street 2:STERLING MEDICAL ASSOCIATES
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45210
Practice Address - Country:US
Practice Address - Phone:800-852-5678
Practice Address - Fax:513-984-4909
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3024721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical