Basic Information
| Provider Information | |||||||||
| NPI: | 1972888451 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FREED | ||||||||
| FirstName: | ADAM | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSYD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9040 FITZSIMMONS DR | ||||||||
| Address2: | |||||||||
| City: | JOINT BASE LEWIS MCCHORD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984311000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539682820 | ||||||||
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| Practice Location | |||||||||
| Address1: | DESMOND T. DOSS HEALTH CLINIC | ||||||||
| Address2: | BLD #: 673 | ||||||||
| City: | SCOFIELD BARRACKS | ||||||||
| State: | HI | ||||||||
| PostalCode: | 96786 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084338686 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2011 | ||||||||
| LastUpdateDate: | 10/01/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 103TC0700X | 685 | WY | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.