Provider Demographics
NPI:1174534143
Name:FREED, SYLVIA (LCSW)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:FREED
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 SHERMAN RD
Mailing Address - Street 2:
Mailing Address - City:OLD BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11804-1423
Mailing Address - Country:US
Mailing Address - Phone:516-694-3823
Mailing Address - Fax:
Practice Address - Street 1:1171 OLD COUNTRY RD
Practice Address - Street 2:SUITE 6
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-5022
Practice Address - Country:US
Practice Address - Phone:516-937-6655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR006093-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N16822Medicare ID - Type UnspecifiedGROUP PRACTICE
N16821Medicare ID - Type UnspecifiedPRIVATE PRACTICE