1275918625 NPI number — MRS. ASHLEY FREECE LPC

Table of content: MRS. ASHLEY FREECE LPC (NPI 1275918625)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275918625 NPI number — MRS. ASHLEY FREECE LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FREECE
Provider First Name:
ASHLEY
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275918625
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1326
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARSHALL
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75671-1326
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-927-3782
Provider Business Mailing Address Fax Number:
903-927-1764

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4077 JEFFERSON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEXARKANA
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71854-1509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-330-9200
Provider Business Practice Location Address Fax Number:
870-330-9439
Provider Enumeration Date:
07/28/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  P1712387 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)