Provider Demographics
NPI:1053582668
Name:FREEMAN CLINICAL COUNSELING CENTER
Entity type:Organization
Organization Name:FREEMAN CLINICAL COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:850-837-8222
Mailing Address - Street 1:P.O. BOX 5733 FREEMAN CLINICAL COUNSELING CENTER
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32540
Mailing Address - Country:US
Mailing Address - Phone:850-837-8222
Mailing Address - Fax:850-837-8280
Practice Address - Street 1:34990 EMERALD COAST PKWY., SUITE 320
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541
Practice Address - Country:US
Practice Address - Phone:850-837-8222
Practice Address - Fax:850-837-8280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-23
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6020101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty