Provider Demographics
NPI:1215579933
Name:LIVING IN FREEDOM COUNSELING
Entity Type:Organization
Organization Name:LIVING IN FREEDOM COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER OF LIVING IN FREEDOM
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:770-864-6847
Mailing Address - Street 1:2540 RIDGECREST DR NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-3439
Mailing Address - Country:US
Mailing Address - Phone:770-864-6847
Mailing Address - Fax:
Practice Address - Street 1:911 N TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-8514
Practice Address - Country:US
Practice Address - Phone:770-765-0988
Practice Address - Fax:770-621-9952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty