Provider Demographics
NPI:1992950471
Name:FREEMAN, ROBERTA (LMSW)
Entity type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ROBERTA
Other - Middle Name:
Other - Last Name:COOPERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:10 SPLIT ROCK CT
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2328
Mailing Address - Country:US
Mailing Address - Phone:631-673-8622
Mailing Address - Fax:
Practice Address - Street 1:380 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:ROOSEVELT
Practice Address - State:NY
Practice Address - Zip Code:11575-1845
Practice Address - Country:US
Practice Address - Phone:516-378-2000
Practice Address - Fax:516-377-2066
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021830-11041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool