Provider Demographics
NPI:1730965948
Name:FREEMAN, JARED DAVID (BS)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:DAVID
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1593 CHATEAU DR
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-6243
Mailing Address - Country:US
Mailing Address - Phone:810-423-8254
Mailing Address - Fax:
Practice Address - Street 1:6050 STATE ROUTE 179 STE 8
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86351-7986
Practice Address - Country:US
Practice Address - Phone:928-284-2690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor