Organization
COUNTRYSIDE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA EDWARD FREEMAN LCSW (OWNER)
(417) 597-4685
Entity
Organization
Contact information
Practice address
313 SOUTH AVE STE 405, SPRINGFIELD, MO 65806-2255
(417) 597-4685
(855) 437-0772
Mailing address
3036 W COUNTRYSIDE DR, SPRINGFIELD, MO 65807-3936
(417) 597-4685
(855) 437-0772
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245796440
—
MO
Enumeration date
12/19/2020
Last updated
12/30/2021
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