Provider Demographics
NPI:1699801746
Name:FREEDLAND, RACHEL N (LLMSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:N
Last Name:FREEDLAND
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8215 BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4505
Mailing Address - Country:US
Mailing Address - Phone:323-655-3668
Mailing Address - Fax:323-655-3819
Practice Address - Street 1:26000 STRATFORD PL
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237
Practice Address - Country:US
Practice Address - Phone:347-439-7098
Practice Address - Fax:347-439-7098
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011023871041C0700X
CAE2962213EP0504X, 213EP1101X, 213ER0200X, 213ES0000X, 213ES0131X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0298310001OtherDMERC
330050229OtherTAX ID NUMBER
CAT19260Medicare UPIN