Provider Demographics
NPI:1992875835
Name:FREAS, MICHAEL JAMES (LISW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JAMES
Last Name:FREAS
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34950 CHARDON RD
Mailing Address - Street 2:DRS FELDMAN SVETE & FOERSTHER LLC
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44094
Mailing Address - Country:US
Mailing Address - Phone:440-510-5100
Mailing Address - Fax:440-510-5151
Practice Address - Street 1:34950 CHARDON RD
Practice Address - Street 2:DRS FELDMAN SVETE & FOERSTHER LLC
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44094
Practice Address - Country:US
Practice Address - Phone:440-510-5100
Practice Address - Fax:440-510-5151
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI885104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH70859OtherQUAL CHOICE
OH399819126004OtherMED MUTUAL HMO HEALTH OH
OH388826OtherANTHEM
OH70859OtherQUAL CHOICE