Healthcare Provider Details

I. General information

NPI: 1356889869
Provider Name (Legal Business Name): FREEMAN PREPARATION PROGRAM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 02/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7441 O ST STE 402
LINCOLN NE
68510-2466
US

IV. Provider business mailing address

7441 O ST STE 402
LINCOLN NE
68510-2466
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-4215
  • Fax: 402-483-5228
Mailing address:
  • Phone: 402-483-4215
  • Fax: 402-483-5228

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: DR. SHELLEY C FREEMAN
Title or Position: PRESIDENT
Credential: PHD, LMHP
Phone: 402-430-3555