Provider Demographics
NPI:1073158333
Name:FRIEL, EDWARD J IV (MA, LPC)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:J
Last Name:FRIEL
Suffix:IV
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 E BALTIMORE PIKE STE 300
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5173
Mailing Address - Country:US
Mailing Address - Phone:610-892-3800
Mailing Address - Fax:484-704-7198
Practice Address - Street 1:1055 E BALTIMORE PIKE STE 300
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5173
Practice Address - Country:US
Practice Address - Phone:610-892-3800
Practice Address - Fax:484-704-7198
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-11
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010371101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional