Provider Demographics
NPI:1679285415
Name:FREEMAN, PEYTON STEWART (LCSW)
Entity type:Individual
Prefix:
First Name:PEYTON
Middle Name:STEWART
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6861 WINCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-8123
Mailing Address - Country:US
Mailing Address - Phone:972-740-6757
Mailing Address - Fax:
Practice Address - Street 1:3710 RAWLINS ST STE 1420
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-4296
Practice Address - Country:US
Practice Address - Phone:972-740-6757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-22
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX657461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical