Provider Demographics
NPI:1083838361
Name:FREEDOM COUNSELING CENTER INC
Entity Type:Organization
Organization Name:FREEDOM COUNSELING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:W
Authorized Official - Last Name:MCVAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-982-7200
Mailing Address - Street 1:1901 NILES AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-1615
Mailing Address - Country:US
Mailing Address - Phone:269-982-7200
Mailing Address - Fax:269-982-0202
Practice Address - Street 1:1901 NILES AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-1615
Practice Address - Country:US
Practice Address - Phone:269-982-7200
Practice Address - Fax:269-982-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301010863103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty