Provider Demographics
NPI:1619277829
Name:FREE THE THERAPIST, LLC
Entity Type:Organization
Organization Name:FREE THE THERAPIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HORAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-206-6577
Mailing Address - Street 1:1016 ALBATROSS LN
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-3558
Mailing Address - Country:US
Mailing Address - Phone:940-206-6577
Mailing Address - Fax:
Practice Address - Street 1:1016 ALBATROSS LN
Practice Address - Street 2:
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-3558
Practice Address - Country:US
Practice Address - Phone:940-206-6577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty