Provider Demographics
NPI:1962002964
Name:FREEMAN, ANDREW JUSTIN (PHD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JUSTIN
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 HUMMINGBIRD HILL AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7046
Mailing Address - Country:US
Mailing Address - Phone:702-788-2820
Mailing Address - Fax:
Practice Address - Street 1:3333 W WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-2207
Practice Address - Country:US
Practice Address - Phone:725-377-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0839103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent