Provider Demographics
NPI:1538548623
Name:FREESE, MARIANA (MSW, LISW)
Entity type:Individual
Prefix:MRS
First Name:MARIANA
Middle Name:
Last Name:FREESE
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:MARIANA
Other - Middle Name:
Other - Last Name:LUNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVENUE
Mailing Address - Street 2:MLC 3014
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4788
Mailing Address - Fax:513-517-0860
Practice Address - Street 1:2030 FAIRFAX AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45207-1943
Practice Address - Country:US
Practice Address - Phone:513-363-7800
Practice Address - Fax:513-363-7820
Is Sole Proprietor?:No
Enumeration Date:2015-05-22
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34008101A1041C0700X
OHI.19015391041C0700X
OHI.1901539-SUPV104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical