MEDICARE: BE FREE COUNSELING SERVICES, 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1477266609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BE FREE COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	229 W CENTRAL AVE UNIT 2107
Second Line	:
City	:	COOLIDGE
State	:	AZ
Zip	:	85128-4850
Country	:	US
Telephone Number	:	520-635-5547
Fax Number	:

Provider Business Practice Location Address
First Line	:	151 W CENTRAL AVE
Second Line	:
City	:	COOLIDGE
State	:	AZ
Zip	:	85128-4405
Country	:	US
Telephone Number	:	520-635-5378
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMANDA IRWIN
Credential	:	LPC
Telephone Number	:	520-635-5547

Provider Enumeration Date	:	01/03/2023
Last Update Date	:	01/04/2023

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