Basic Information
Provider Information
NPI: 1346564952
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FREEMAN
FirstName: JASMIN
MiddleName: M.
NamePrefix: MRS.
NameSuffix:  
Credential: MSW, LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 501 W 14TH ST STE 1E40
Address2:  
City: WILMINGTON
State: DE
PostalCode: 198011013
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 501 W 14TH ST STE 1E40
Address2:  
City: WILMINGTON
State: DE
PostalCode: 198011013
CountryCode: US
TelephoneNumber: 3023202100
FaxNumber: 3023202121
Other Information
ProviderEnumerationDate: 03/25/2010
LastUpdateDate: 01/28/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XCW016817PAN Behavioral Health & Social Service ProvidersSocial WorkerClinical
1041C0700XQ1-0001289DEY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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