Individual
JEFF E FREEMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
9670 E WASHINGTON ST STE 120, INDIANAPOLIS, IN 46229-3051
(317) 865-6922
(317) 865-6930
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87000267A
IN
1041C0700X
Clinical Social Worker
Primary
34002898A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M400028675
MEDICARE PIN
IN
Enumeration date
06/16/2006
Last updated
04/28/2020
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