NPIMap

Organization Active NPI

Freedom Counseling Center Inc

  • Counseling Psychologist
  • Saint Joseph, MI
National Provider Identifier
1083838361
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
6301010863 Issued in MI
Legal business name
FREEDOM COUNSELING CENTER INC
Practice address
1901 Niles Ave
Suite 102
Saint Joseph, MI 49085-1615
Phone
(269) 982-7200
Fax
(269) 982-0202
NPI assigned
Apr 11, 2007
Last updated
Dec 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Timothy W. McVayNPI 1730336926
Title
President
Phone
(269) 982-7200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 6301010863 MI Primary

Addresses

Primary practice location

1901 Niles Ave
Suite 102
Saint Joseph, MI 49085-1615

Mailing address

1901 Niles Ave
Suite 102
Saint Joseph, MI 49085-1615
Phone (269) 982-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140206000859 MI Part B Supplier - Clinic/Group Practice 6608005046 Receives reassigned benefits from 7 practitioners
Practice locations: Saint Joseph, MI

National Provider Directory

National Provider Directory

Locations

1901 Niles Ave
Ste 102
Saint Joseph, MI 49085
Phone (269) 982-7200

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701993600000",
    "number": "1083838361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 NILES AVE",
            "address_2": "SUITE 102",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851615",
            "telephone_number": "269-982-7200",
            "fax_number": "269-982-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 NILES AVE",
            "address_2": "SUITE 102",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851615",
            "telephone_number": "269-982-7200",
            "fax_number": "269-982-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM COUNSELING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A",
        "authorized_official_last_name": "MCVAY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-982-7200"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301010863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.