Provider Demographics
NPI:1356935274
Name:FREEMAN-WELLS, CORRYN NICOLE
Entity type:Individual
Prefix:MS
First Name:CORRYN
Middle Name:NICOLE
Last Name:FREEMAN-WELLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4415 EUCLID AVE.
Mailing Address - Street 2:STE 315
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103
Mailing Address - Country:US
Mailing Address - Phone:216-465-2000
Mailing Address - Fax:
Practice Address - Street 1:4415 EUCLID AVE STE 315
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-3759
Practice Address - Country:US
Practice Address - Phone:216-465-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician