=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669833679
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A FREEMAN'S PLACE COUNSELING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/18/2016
-----------------------------------------------------
Last Update Date | 01/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 190 HIGHWAY 18
-----------------------------------------------------
City | EAST BRUNSWICK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08816-1407
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-333-8520
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 190 HIGHWAY 18 STE 304
-----------------------------------------------------
City | EAST BRUNSWICK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08816-1407
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-333-8520
-----------------------------------------------------
Fax | 732-333-8530
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | DR. BRITTANY FREEMAN-ANDERSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 732-333-8520
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | 37PC00512300
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------