Provider Demographics
NPI:1679254684
Name:FREEMAN, SUSAN MICHELLE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:MICHELLE
Last Name:FREEMAN
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 1:307 MEADOWLARK LN
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75603-7626
Mailing Address - Country:US
Mailing Address - Phone:903-720-8807
Mailing Address - Fax:
Practice Address - Street 1:1800 JUDSON RD STE 2000
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-4743
Practice Address - Country:US
Practice Address - Phone:903-720-8807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1034661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical