Provider Demographics
NPI:1194413468
Name:FREEMAN, JOHN D (CCC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 WARNER AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3607
Mailing Address - Country:US
Mailing Address - Phone:150-283-6564
Mailing Address - Fax:
Practice Address - Street 1:3411 WARNER AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3607
Practice Address - Country:US
Practice Address - Phone:150-283-6564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor