Provider Demographics
NPI:1023397734
Name:FRIEDMAN, MELISSA SUE (LCSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:SUE
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 S PONTIAC WAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-1549
Mailing Address - Country:US
Mailing Address - Phone:901-305-7175
Mailing Address - Fax:866-860-2125
Practice Address - Street 1:2821 S PARKER RD STE 165
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2748
Practice Address - Country:US
Practice Address - Phone:901-305-7175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000070501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical