Provider Demographics
NPI:1417721473
Name:FREESIA THERAPY COLLECTIVE PLLC
Entity Type:Organization
Organization Name:FREESIA THERAPY COLLECTIVE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:253-455-0931
Mailing Address - Street 1:6226 213TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:LAKE TAPPS
Mailing Address - State:WA
Mailing Address - Zip Code:98391-6134
Mailing Address - Country:US
Mailing Address - Phone:253-455-0931
Mailing Address - Fax:
Practice Address - Street 1:6226 213TH AVENUE CT E
Practice Address - Street 2:
Practice Address - City:LAKE TAPPS
Practice Address - State:WA
Practice Address - Zip Code:98391-6134
Practice Address - Country:US
Practice Address - Phone:253-455-0931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty