Provider Demographics
NPI:1093420275
Name:FRIEDMAN, JONAH (MA)
Entity Type:Individual
Prefix:MR
First Name:JONAH
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2062 LOMBARD ST APT 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1315
Mailing Address - Country:US
Mailing Address - Phone:908-574-9612
Mailing Address - Fax:
Practice Address - Street 1:2062 LOMBARD ST APT 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1315
Practice Address - Country:US
Practice Address - Phone:908-574-9612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00698900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health