Provider Demographics
NPI:1093867152
Name:FRIEDMAN, BETTY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BETTY
Middle Name:
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 1:1525 NE WEIDLER ST
Mailing Address - Street 2:STE. 202
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-1410
Mailing Address - Country:US
Mailing Address - Phone:503-525-1142
Mailing Address - Fax:503-287-0212
Practice Address - Street 1:1525 NE WEIDLER ST
Practice Address - Street 2:STE. 202
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1410
Practice Address - Country:US
Practice Address - Phone:503-525-1142
Practice Address - Fax:503-287-0212
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical