Basic Information
| Provider Information | |||||||||
| NPI: | 1285861765 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FREEMAN | ||||||||
| FirstName: | ELLEN | ||||||||
| MiddleName: | CECELIA | ||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2744 KEATING ST | ||||||||
| Address2: | |||||||||
| City: | TEMPLE HILLS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207481512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3014232958 | ||||||||
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| Practice Location | |||||||||
| Address1: | 411 OAK ST. | ||||||||
| Address2: | STERLING MEDICAL ASSOCIATES | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008525678 | ||||||||
| FaxNumber: | 5139844909 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2009 | ||||||||
| LastUpdateDate: | 06/11/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LC302472 | DC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.