Provider Demographics
NPI:1508451188
Name:FREEDMAN, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:FREEDMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6504 NASHVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-3427
Mailing Address - Country:US
Mailing Address - Phone:440-840-7037
Mailing Address - Fax:
Practice Address - Street 1:400 N 5TH ST STE 201
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-1808
Practice Address - Country:US
Practice Address - Phone:636-238-2615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-04
Last Update Date:2025-09-11
Deactivation Date:2021-08-08
Deactivation Code:
Reactivation Date:2021-10-05
Provider Licenses
StateLicense IDTaxonomies
MO2025017856104100000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician