Provider Demographics
NPI:1306914197
Name:FREIREICH, NAOMI ANNE (LMSW)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:ANNE
Last Name:FREIREICH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 WEST AVE STE B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1555
Mailing Address - Country:US
Mailing Address - Phone:512-306-0180
Mailing Address - Fax:512-586-2085
Practice Address - Street 1:1605 WEST AVE STE B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1555
Practice Address - Country:US
Practice Address - Phone:512-306-0180
Practice Address - Fax:512-586-2085
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX206071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical