Provider Demographics
NPI:1366964876
Name:FREEDENBERG, CAROLINE STALLINGS (LICSW)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:STALLINGS
Last Name:FREEDENBERG
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1487 CHAIN BRIDGE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-5723
Mailing Address - Country:US
Mailing Address - Phone:703-923-8965
Mailing Address - Fax:
Practice Address - Street 1:2001 MASSACHUSETTS AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1011
Practice Address - Country:US
Practice Address - Phone:703-923-8965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD296341041C0700X
VA0904153531041C0700X
DCLC500805741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical