Provider Demographics
NPI:1366885543
Name:FREEMAN, VALORA LEE (LCPC)
Entity type:Individual
Prefix:
First Name:VALORA
Middle Name:LEE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:VALORA
Other - Middle Name:LEE
Other - Last Name:WADMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-2510
Mailing Address - Country:US
Mailing Address - Phone:406-454-6973
Mailing Address - Fax:406-791-9277
Practice Address - Street 1:202 2ND AVE S STE 201
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-1831
Practice Address - Country:US
Practice Address - Phone:406-454-6973
Practice Address - Fax:406-791-9277
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-4504101YP2500X
MT4504101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000748560OtherBLUE CROSS-SHIELD OF MONTANA
MT1366885543Medicaid