Provider Demographics
NPI:1912473836
Name:FOLK-FREUND, KATELYN ELIZABETH (LMSW)
Entity type:Individual
Prefix:MRS
First Name:KATELYN
Middle Name:ELIZABETH
Last Name:FOLK-FREUND
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 KIMBERLY AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11738-2268
Mailing Address - Country:US
Mailing Address - Phone:631-645-7946
Mailing Address - Fax:
Practice Address - Street 1:2 ROOSEVELT AVE STE 300
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-3064
Practice Address - Country:US
Practice Address - Phone:516-912-4460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104821-1104100000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker