Provider Demographics
NPI:1548748981
Name:FREEMAN, ERIC SCOTT (LCMHC)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:SCOTT
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 N SUMMER WAY
Mailing Address - Street 2:
Mailing Address - City:EAGLE MOUNTAIN
Mailing Address - State:UT
Mailing Address - Zip Code:84005-4283
Mailing Address - Country:US
Mailing Address - Phone:801-623-8713
Mailing Address - Fax:
Practice Address - Street 1:1404 W STATE RD STE 206
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-5041
Practice Address - Country:US
Practice Address - Phone:801-623-8713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-28
Last Update Date:2018-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT90108276004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health