Provider Demographics
NPI:1033460027
Name:FREEMAN, JILL ANDREA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:ANDREA
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 HARBOR OAKS DR
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-1708
Mailing Address - Country:US
Mailing Address - Phone:727-286-0740
Mailing Address - Fax:727-279-4644
Practice Address - Street 1:2708 ALT 19 STE 507-12
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-2665
Practice Address - Country:US
Practice Address - Phone:727-286-0740
Practice Address - Fax:727-279-4644
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-01
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLMH13784101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health