Provider Demographics
NPI:1447714480
Name:FREEMAN, NASTASIA MARIE (LPCC, LMHC, LPC)
Entity type:Individual
Prefix:MRS
First Name:NASTASIA
Middle Name:MARIE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LPCC, LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45358 TESIBEN CT
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-5792
Mailing Address - Country:US
Mailing Address - Phone:214-684-1748
Mailing Address - Fax:
Practice Address - Street 1:45358 TESIBEN CT
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-5792
Practice Address - Country:US
Practice Address - Phone:904-909-0389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-23
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93111101YM0800X
FLMH19562101YM0800X
CA14658101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health