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General NPI Number Information
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NPI Number | 1053582668
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Entity Type | Organization
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Legal Business Name | FREEMAN CLINICAL COUNSELING CENTER
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Dates
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Enumeration Date | 03/23/2008
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 34990 EMERALD COAST PKWY., SUITE 320
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City | DESTIN
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State | FL
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Zip | 32541
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Country | US
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Telephone | 850-837-8222
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Fax | 850-837-8280
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Provider Business Mailing Address
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Address Line | P.O. BOX 5733 FREEMAN CLINICAL COUNSELING CENTER
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City | DESTIN
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State | FL
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Zip | 32540
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Country | US
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Telephone | 850-837-8222
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Fax | 850-837-8280
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | MS. TONYA KAY FREEMAN
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Credential | LMHC
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Telephone | 850-837-8222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH6020
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License Number State | FL
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