Provider Demographics
NPI:1871169060
Name:FREEMAN, EVELYNN RACHEL (PLMHP)
Entity type:Individual
Prefix:
First Name:EVELYNN
Middle Name:RACHEL
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:ERIC
Other - Middle Name:JOHN
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7553 LAWNDALE DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-4438
Mailing Address - Country:US
Mailing Address - Phone:402-401-4119
Mailing Address - Fax:
Practice Address - Street 1:7553 LAWNDALE DR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-4438
Practice Address - Country:US
Practice Address - Phone:402-401-4119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-28
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12626101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE12626OtherSTATE PLMHP LICENSE