Healthcare Provider Details

I. General information

NPI: 1992511919
Provider Name (Legal Business Name): FREEDOM COUNSELING MENTAL HEALTH AND WELLNESS SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

682 PROSPECT AVE # 302
HARTFORD CT
06105-4238
US

IV. Provider business mailing address

682 PROSPECT AVE # 302
HARTFORD CT
06105-4238
US

V. Phone/Fax

Practice location:
  • Phone: 860-578-2369
  • Fax:
Mailing address:
  • Phone: 860-578-2369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TANGEL MCFADDEN
Title or Position: THERAPIST
Credential: LCSW
Phone: 860-578-2369