MEDICARE: FREEDOM BOUND HEALTH 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	101YP2500X	Professional Counselor	E.0700354	OH

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821505389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEDOM BOUND HEALTH COUNSELING, LLC

Provider Business Mailing Address
First Line	:	352 CENTER STREET
Second Line	:	SUITE 218
City	:	MIAMIVILLE
State	:	OH
Zip	:	45147-0218
Country	:	US
Telephone Number	:	513-722-5694
Fax Number	:

Provider Business Practice Location Address
First Line	:	352 CENTER STREET
Second Line	:	SUITE 218
City	:	MIAMIVILLE
State	:	OH
Zip	:	45147-0218
Country	:	US
Telephone Number	:	513-722-5694
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. KIMBERLY PODRATZ
Credential	:	LPCC
Telephone Number	:	513-722-5694

Provider Enumeration Date	:	01/05/2018
Last Update Date	:	01/25/2024

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