Provider Demographics
NPI:1023639317
Name:FREEDOM WORK COUNSELING AND CONSULTING LLC
Entity type:Organization
Organization Name:FREEDOM WORK COUNSELING AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EQUAL OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:765-273-3224
Mailing Address - Street 1:114 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47305-1734
Mailing Address - Country:US
Mailing Address - Phone:765-273-3224
Mailing Address - Fax:
Practice Address - Street 1:114 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47305-1734
Practice Address - Country:US
Practice Address - Phone:765-273-3224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-28
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN39001514AOtherPROFESSIONAL LICENSE