Individual
FREEMAN M CHAKARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
219 W MAIN ST, LEOLA, PA 17540-1753
(717) 556-0149
(717) 556-0149
Mailing address
2003 OLD ROTHSVILLE RD, LITITZ, PA 17543-9133
(717) 556-0149
(717) 556-0149
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PS009409
PA
103TC0700X
Clinical Psychologist
PS009409
PA
103TS0200X
School Psychologist
PS009409
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001334567
HIGHMARK BLUE SHIELD
PA
05
—
0018978580002
—
PA
01
—
02271001
CAPITAL BLUE CROSS
PA
01
—
1548470
GATEWAY MEDICARE ASSURED
PA
01
—
680015251
RAILROAD MEDICARE
PA
Enumeration date
05/16/2006
Last updated
07/02/2013
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