Provider Demographics
NPI:1386700904
Name:FREEMAN, JUDITH ELLETT (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:ELLETT
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 WESTFIELD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1725
Mailing Address - Country:US
Mailing Address - Phone:434-974-9765
Mailing Address - Fax:434-973-0756
Practice Address - Street 1:535 WESTFIELD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1725
Practice Address - Country:US
Practice Address - Phone:434-974-9765
Practice Address - Fax:434-973-0756
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904001340101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health