Provider Demographics
NPI:1295810703
Name:FREEMAN, TERESA (MS, LMHP)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MS, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7561 MAIN ST
Mailing Address - Street 2:SUITE 425
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-3981
Mailing Address - Country:US
Mailing Address - Phone:402-558-7788
Mailing Address - Fax:402-558-8224
Practice Address - Street 1:7561 MAIN ST
Practice Address - Street 2:SUITE 425
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-3981
Practice Address - Country:US
Practice Address - Phone:402-558-7788
Practice Address - Fax:402-558-8224
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2782101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025161900Medicaid