Provider Demographics
NPI:1750937363
Name:FREE SPIRIT COUNSELING LLC
Entity type:Organization
Organization Name:FREE SPIRIT COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED INDEPENDENT SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ACACIA
Authorized Official - Middle Name:GABRIELLE
Authorized Official - Last Name:QUAINTANCE
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:330-814-6384
Mailing Address - Street 1:5587 READERS ST
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-8328
Mailing Address - Country:US
Mailing Address - Phone:330-814-6384
Mailing Address - Fax:
Practice Address - Street 1:1069 W BROAD ST STE 1008
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43222-1440
Practice Address - Country:US
Practice Address - Phone:614-681-1460
Practice Address - Fax:614-639-8228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-11
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty