Provider Demographics
NPI:1215057625
Name:FREEMAN, SHELLEY ELIZABETH (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:ELIZABETH
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 HUFF DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-7369
Mailing Address - Country:US
Mailing Address - Phone:910-353-4414
Mailing Address - Fax:910-353-2972
Practice Address - Street 1:250 HUFF DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7369
Practice Address - Country:US
Practice Address - Phone:910-353-4414
Practice Address - Fax:910-353-2972
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8513101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8513OtherNORTH CAROLINA BOARD OF LICENSED PROFESSIONAL COUNSELORS