Provider Demographics
NPI:1780307108
Name:FREEMAN, ALEXANDRA JADE (LPC)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:JADE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials: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 688
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KS
Mailing Address - Zip Code:67301-0688
Mailing Address - Country:US
Mailing Address - Phone:620-331-1748
Mailing Address - Fax:620-332-1940
Practice Address - Street 1:22214 D ST
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-7376
Practice Address - Country:US
Practice Address - Phone:620-221-9664
Practice Address - Fax:620-442-4559
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional