Provider Demographics
NPI:1679978159
Name:FREEMAN, TERESA KAY (MSW MS, LCSW,LCAS)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:KAY
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MSW MS, LCSW,LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 PONDEROSA DR
Mailing Address - Street 2:
Mailing Address - City:HAMLET
Mailing Address - State:NC
Mailing Address - Zip Code:28345-4349
Mailing Address - Country:US
Mailing Address - Phone:910-434-2212
Mailing Address - Fax:
Practice Address - Street 1:289 OLMSTED BLVD
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8729
Practice Address - Country:US
Practice Address - Phone:910-295-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14993101Y00000X, 101YA0400X
101Y00000X, 101YM0800X, 101YP2500X, 104100000X, 171M00000X
NCC0116601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator