Healthcare Provider Details

I. General information

NPI: 1528974193
Provider Name (Legal Business Name): FREEDOM AFTER SERVING TIME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2414 CONGRESS ST
NEW ORLEANS LA
70117-5803
US

IV. Provider business mailing address

4545 ENGRAM DR APT 2114
GULFPORT MS
39501-3642
US

V. Phone/Fax

Practice location:
  • Phone: 504-218-6646
  • Fax:
Mailing address:
  • Phone: 504-920-6892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. REGINA GARDNER
Title or Position: DIRECTOR
Credential:
Phone: 504-920-9862