Provider Demographics
NPI:1215454145
Name:FREEMAN, EBONY (LMFT)
Entity type:Individual
Prefix:
First Name:EBONY
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5121 STOCKDALE HWY STE 150
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-2665
Mailing Address - Country:US
Mailing Address - Phone:661-868-5062
Mailing Address - Fax:
Practice Address - Street 1:5121 STOCKDALE HWY STE 150
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-2665
Practice Address - Country:US
Practice Address - Phone:661-868-5062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT99974106H00000X
CALMFT132177106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist