Provider Demographics
NPI:1568486140
Name:FREELS MENTAL HEALTH GROUP, PA
Entity Type:Organization
Organization Name:FREELS MENTAL HEALTH GROUP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FREELS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:954-776-6544
Mailing Address - Street 1:3081 E COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4380
Mailing Address - Country:US
Mailing Address - Phone:954-776-6544
Mailing Address - Fax:954-776-5573
Practice Address - Street 1:3081 E COMMERCIAL BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4380
Practice Address - Country:US
Practice Address - Phone:954-776-6544
Practice Address - Fax:954-776-5573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0004377101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty