Provider Demographics
NPI:1962645853
Name:FREEDOM PSYCHIATRY, PLLC
Entity Type:Organization
Organization Name:FREEDOM PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:606-776-6309
Mailing Address - Street 1:489 HAMMER MILL RD
Mailing Address - Street 2:
Mailing Address - City:WURTLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41144-7798
Mailing Address - Country:US
Mailing Address - Phone:606-776-6309
Mailing Address - Fax:800-650-1424
Practice Address - Street 1:489 HAMMER MILL RD
Practice Address - Street 2:
Practice Address - City:WURTLAND
Practice Address - State:KY
Practice Address - Zip Code:41144-7798
Practice Address - Country:US
Practice Address - Phone:606-776-6309
Practice Address - Fax:800-650-1424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5507P163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty