MEDICARE: FREEDOM FAMILY COUNSELING, 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	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649895129
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEDOM FAMILY COUNSELING, LLC

Provider Business Mailing Address
First Line	:	17250 N 43RD AVE STE 4
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-4032
Country	:	US
Telephone Number	:	623-695-8733
Fax Number	:

Provider Business Practice Location Address
First Line	:	17250 N 43RD AVE STE 4
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-4032
Country	:	US
Telephone Number	:	623-695-8733
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NANCY FRIGAARD
Credential	:
Telephone Number	:	623-810-8590

Provider Enumeration Date	:	06/10/2020
Last Update Date	:	05/26/2026

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