Provider Demographics
NPI:1821505389
Name:FREEDOM BOUND HEALTH COUNSELING, LLC
Entity Type:Organization
Organization Name:FREEDOM BOUND HEALTH COUNSELING, LLC
Other - Org Name:FBH COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PODRATZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:513-722-5694
Mailing Address - Street 1:352 CENTER STREET
Mailing Address - Street 2:SUITE 218
Mailing Address - City:MIAMIVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45147-0218
Mailing Address - Country:US
Mailing Address - Phone:513-722-5694
Mailing Address - Fax:
Practice Address - Street 1:352 CENTER STREET
Practice Address - Street 2:SUITE 218
Practice Address - City:MIAMIVILLE
Practice Address - State:OH
Practice Address - Zip Code:45147-0218
Practice Address - Country:US
Practice Address - Phone:513-722-5694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-05
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0700354101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0205690Medicaid
OH0261152Medicaid