Provider Demographics
NPI:1063771459
Name:FREELAND, JENNIE KAYE (MSED, LMHC)
Entity type:Individual
Prefix:MRS
First Name:JENNIE
Middle Name:KAYE
Last Name:FREELAND
Suffix:
Gender:F
Credentials:MSED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7435 LOMBARDI DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-2804
Mailing Address - Country:US
Mailing Address - Phone:317-995-0328
Mailing Address - Fax:317-973-6091
Practice Address - Street 1:7435 LOMBARDI DR
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-2804
Practice Address - Country:US
Practice Address - Phone:317-995-0328
Practice Address - Fax:317-973-6091
Is Sole Proprietor?:No
Enumeration Date:2012-05-07
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.006853101YM0800X
IN39002547A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health