NPIMap

Organization Active NPI

Freedom Recovery Center LLC

  • Addiction (Substance Use Disorder) Counselor
  • Bonney Lake, WA
National Provider Identifier
1487884441
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CP0002606 Issued in WA
Legal business name
FREEDOM RECOVERY CENTER LLC
Practice address
10215 214TH Ave E
Bonney Lake, WA 98391-3909
Phone
(253) 862-7374
Fax
(253) 862-0448
NPI assigned
Jul 23, 2009
Last updated
Feb 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Authorized official

Name
Robert W Long, COUNSELORNPI 1508908880
Title
Provider/Owner
Phone
(253) 862-7374

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
Addiction (Substance Use Disorder) Counselor 101YA0400X CP0002606 WA Primary

Addresses

Primary practice location

10215 214TH Ave E
Bonney Lake, WA 98391-3909

Mailing address

10215 214TH Ave E
Bonney Lake, WA 98391-3909
Phone (253) 862-7374

Other identifiers 1

IdentifierTypeStateIssuer
CP00002606OtherWACOUNSELOR REGISTRATION

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1487884441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10215 214TH AVE E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983913909",
            "telephone_number": "253-862-7374",
            "fax_number": "253-862-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10215 214TH AVE E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983913909",
            "telephone_number": "253-862-7374",
            "fax_number": "253-862-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM RECOVERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-23",
        "last_updated": "2013-02-28",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "253-862-7374",
        "authorized_official_credential": "COUNSELOR"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP0002606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNSELOR REGISTRATION",
            "identifier": "CP00002606",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.