Provider Demographics
NPI:1700942836
Name:FREEMAN, WILLIAM EUGENE (MED, LPC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:EUGENE
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 757
Mailing Address - Street 2:
Mailing Address - City:ETOWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37331-0757
Mailing Address - Country:US
Mailing Address - Phone:423-263-0019
Mailing Address - Fax:423-263-0019
Practice Address - Street 1:600 ATHENS PIKE
Practice Address - Street 2:
Practice Address - City:ETOWAH
Practice Address - State:TN
Practice Address - Zip Code:37331-1706
Practice Address - Country:US
Practice Address - Phone:423-263-2966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1653101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional