Provider Demographics
NPI:1114159183
Name:FRIEDER, MELISSA CARIDAD (LMHC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:CARIDAD
Last Name:FRIEDER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11031 NE 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-7182
Mailing Address - Country:US
Mailing Address - Phone:305-398-6100
Mailing Address - Fax:305-757-4465
Practice Address - Street 1:6175 NW 153RD ST
Practice Address - Street 2:404
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-2435
Practice Address - Country:US
Practice Address - Phone:305-558-7400
Practice Address - Fax:305-558-6134
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9127101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001360100Medicaid