Provider Demographics
NPI:1033621990
Name:FREEDOM SUPPORT SERVICES
Entity Type:Organization
Organization Name:FREEDOM SUPPORT SERVICES
Other - Org Name:REAL LOVE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:540-230-7178
Mailing Address - Street 1:1115 CROSSCREEK DR
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-4167
Mailing Address - Country:US
Mailing Address - Phone:540-230-7178
Mailing Address - Fax:
Practice Address - Street 1:900 LIFE DR STE B
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-7382
Practice Address - Country:US
Practice Address - Phone:540-230-7178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-01
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty