Provider Demographics
NPI:1497631758
Name:FREEMAN, ASHLEY JO (LLMSW, EMT-B)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:JO
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LLMSW, EMT-B
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:JO
Other - Last Name:RIESCHICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9485 LIGHTHOUSE DR
Mailing Address - Street 2:
Mailing Address - City:IRA
Mailing Address - State:MI
Mailing Address - Zip Code:48023-2828
Mailing Address - Country:US
Mailing Address - Phone:586-872-7008
Mailing Address - Fax:
Practice Address - Street 1:3901 CHRYSLER DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2167
Practice Address - Country:US
Practice Address - Phone:313-993-3964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2000348146N00000X
MI68511203801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic