Provider Demographics
NPI:1073237343
Name:FREEDOM FIGHTERS THERAPY, LLC
Entity type:Organization
Organization Name:FREEDOM FIGHTERS THERAPY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERALYN
Authorized Official - Middle Name:R
Authorized Official - Last Name:THARP
Authorized Official - Suffix:
Authorized Official - Credentials:MEED, LPCC-S, LICDC
Authorized Official - Phone:850-889-2880
Mailing Address - Street 1:2186 JACKSON KELLER RD
Mailing Address - Street 2:SUITE 2223
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213
Mailing Address - Country:US
Mailing Address - Phone:210-405-8981
Mailing Address - Fax:937-962-6210
Practice Address - Street 1:12 WEST WENGER ROAD,
Practice Address - Street 2:SUITE S
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322
Practice Address - Country:US
Practice Address - Phone:210-405-8981
Practice Address - Fax:937-962-6210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-30
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty