Provider Demographics
NPI:1851712368
Name:FREEDOM COUNSELING LLC
Entity Type:Organization
Organization Name:FREEDOM COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEASE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:520-720-6488
Mailing Address - Street 1:880 W 4TH STREET
Mailing Address - Street 2:PO BOX 956
Mailing Address - City:BENSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85602-9603
Mailing Address - Country:US
Mailing Address - Phone:520-720-6488
Mailing Address - Fax:520-720-6486
Practice Address - Street 1:880 W 4TH STREET
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:AZ
Practice Address - Zip Code:85602-9603
Practice Address - Country:US
Practice Address - Phone:520-720-6488
Practice Address - Fax:520-720-6486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-31
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW11623251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ111418Medicare PIN