Provider Demographics
NPI:1093011959
Name:FRIEDMAN, ELLEN C (LPC)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:C
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 W WILLIAM CANNON DR
Mailing Address - Street 2:BUILDING 6
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5281
Mailing Address - Country:US
Mailing Address - Phone:512-344-9181
Mailing Address - Fax:
Practice Address - Street 1:2501 W WILLIAM CANNON DR
Practice Address - Street 2:BUILDING 6
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5281
Practice Address - Country:US
Practice Address - Phone:512-344-9181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-09
Last Update Date:2016-05-05
Deactivation Date:2014-07-28
Deactivation Code:
Reactivation Date:2015-11-12
Provider Licenses
StateLicense IDTaxonomies
TX19077101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health