# FREEDOM FORMULA RX, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811762982
- **Authorized official:** MRS. ABBI JONES PRUITT NCC, LPC-S, LMSW (OWNER/CLINICAL DIRECTOR)
- **Authorized official phone:** (409) 225-6044

## Contact information

- **Practice address:** 14405 WALTERS RD STE 1016, HOUSTON, TX 77014-1493
- **Practice address phone:** (832) 559-7520
- **Practice address fax:** (832) 559-7284
- **Mailing address:** 18806 CENTERRA SPRINGS DR, CYPRESS, TX 77429-7598
- **Mailing address phone:** (409) 225-6044

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |
| 171400000X | Health & Wellness Coach | — | NULL | — |
| 171400000X | Health & Wellness Coach | — | — | — |
| 174H00000X | Health Educator | — | NULL | — |
| 174H00000X | Health Educator | — | — | — |

## Other

- **Enumeration date:** 11/20/2023
- **Last updated:** 11/20/2023