Provider Demographics
NPI:1447659354
Name:FREIRICH, BONNIE LYN (LCSW)
Entity type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:LYN
Last Name:FREIRICH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:BONNIE
Other - Middle Name:FREIRICH
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:87 ROUTE 17 NORTH
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07607
Mailing Address - Country:US
Mailing Address - Phone:551-996-4450
Mailing Address - Fax:551-996-5729
Practice Address - Street 1:87 ROUTE 17 NORTH
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607
Practice Address - Country:US
Practice Address - Phone:551-996-4450
Practice Address - Fax:551-996-5729
Is Sole Proprietor?:No
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCO55870001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical