Provider Demographics
NPI:1679911598
Name:FREEMAN, DAVID (MA NCC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MA NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4511 GUNBARREL DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80925-1036
Mailing Address - Country:US
Mailing Address - Phone:719-244-2512
Mailing Address - Fax:
Practice Address - Street 1:3 CARSON CIR
Practice Address - Street 2:
Practice Address - City:FOUNTAIN
Practice Address - State:CO
Practice Address - Zip Code:80817-1039
Practice Address - Country:US
Practice Address - Phone:719-244-2512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13113101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor