Provider Demographics
NPI:1417363219
Name:FREUND, ROBERT RUSSELL (MED, LMHC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:RUSSELL
Last Name:FREUND
Suffix:
Gender:M
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 PENINSULA CORPORATE CIR
Mailing Address - Street 2:SUITE 3002
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1378
Mailing Address - Country:US
Mailing Address - Phone:561-288-8528
Mailing Address - Fax:
Practice Address - Street 1:950 PENINSULA CORPORATE CIR
Practice Address - Street 2:SUITE 3002
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1378
Practice Address - Country:US
Practice Address - Phone:561-288-8528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 14002101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health