Provider Demographics
NPI:1871666792
Name:FREELAND, KENT W (IMFT,PCC-S,LMFT,LCPC)
Entity Type:Individual
Prefix:MR
First Name:KENT
Middle Name:W
Last Name:FREELAND
Suffix:
Gender:M
Credentials:IMFT,PCC-S,LMFT,LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT CARMEL
Mailing Address - State:IL
Mailing Address - Zip Code:62863-1212
Mailing Address - Country:US
Mailing Address - Phone:618-263-4970
Mailing Address - Fax:
Practice Address - Street 1:2675 MEDWAY NEW CARLISLE RD
Practice Address - Street 2:
Practice Address - City:MEDWAY
Practice Address - State:OH
Practice Address - Zip Code:45341-9744
Practice Address - Country:US
Practice Address - Phone:937-849-1257
Practice Address - Fax:937-849-1336
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-004315101YP2500X
OHE 09000386101YP2500X
IL166-000606106H00000X
OHF0900002106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional