Provider Demographics
NPI:1679624357
Name:FREEMAN, RON (EDD, LPC, LMFT)
Entity type:Individual
Prefix:
First Name:RON
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:EDD, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1942
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72702-1942
Mailing Address - Country:US
Mailing Address - Phone:479-443-9707
Mailing Address - Fax:479-443-4504
Practice Address - Street 1:65 E SUNBRIDGE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2894
Practice Address - Country:US
Practice Address - Phone:479-443-9707
Practice Address - Fax:479-443-4504
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP8108209101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health