Provider Demographics
NPI:1861979791
Name:FREEMAN-LYNDE, PATRICIA ANNE
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANNE
Last Name:FREEMAN-LYNDE
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 1:26 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-5034
Mailing Address - Country:US
Mailing Address - Phone:706-254-2178
Mailing Address - Fax:
Practice Address - Street 1:26 FRONT ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-5034
Practice Address - Country:US
Practice Address - Phone:706-254-2178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223040104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker