MEDICARE: BREAKING FREE COUNSELING AND CONSULTING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1033966726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BREAKING FREE COUNSELING AND CONSULTING, LLC

Provider Business Mailing Address
First Line	:	24 N POPLAR ST
Second Line	:
City	:	ELIZABETHTOWN
State	:	PA
Zip	:	17022-2027
Country	:	US
Telephone Number	:	717-383-5708
Fax Number	:

Provider Business Practice Location Address
First Line	:	2951 WHITEFORD RD STE 201
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-7624
Country	:	US
Telephone Number	:	717-383-5708
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	MS. MELISSA M WHITMAN
Credential	:	LPC
Telephone Number	:	717-383-5708

Provider Enumeration Date	:	05/01/2024
Last Update Date	:	05/01/2024

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