MEDICARE: MISS TONYA K FREEMAN LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH 6020	FL
2	101YM0800X	Mental Health Counselor	MH6020	FL

General Provider Information

NPI Number	:	1992708432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS TONYA K FREEMAN LMHC

Provider Business Mailing Address
First Line	:	FREEMAN CLINICAL COUNSELING CENTER P.O. BOX 5733
Second Line	:
City	:	DESTIN
State	:	FL
Zip	:	32540
Country	:	US
Telephone Number	:	850-837-8222
Fax Number	:	850-837-8280

Provider Business Practice Location Address
First Line	:	34990 EMERALD COAST PKWY STE 320
Second Line	:
City	:	DESTIN
State	:	FL
Zip	:	32541-8662
Country	:	US
Telephone Number	:	850-837-8222
Fax Number	:	850-837-8280

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2005
Last Update Date	:	02/22/2024

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