MEDICARE: FREEDOM COUNSELING AND CONSULTING 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	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCA051	MD

General Provider Information

NPI Number	:	1700066701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEDOM COUNSELING AND CONSULTING SERVICES, LLC

Provider Business Mailing Address
First Line	:	1921 E BALTIMORE ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21231-1902
Country	:	US
Telephone Number	:	443-869-2517
Fax Number	:

Provider Business Practice Location Address
First Line	:	1921 E BALTIMORE ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21231-1902
Country	:	US
Telephone Number	:	443-869-2517
Fax Number	:

Authorized Official
Title or Position	:	CEO AND PSYCHOTHERAPIST
Name	:	MR. FRANCISCO XAVIER CUMMINGS
Credential	:	MHS, LCADC
Telephone Number	:	443-869-2517

Provider Enumeration Date	:	11/07/2007
Last Update Date	:	11/07/2007

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