Provider Demographics
NPI:1114401817
Name:FRIEDMAN, AMY SUZANNE (LPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:SUZANNE
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 1:106 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-2928
Mailing Address - Country:US
Mailing Address - Phone:216-544-4156
Mailing Address - Fax:
Practice Address - Street 1:6200 SOM CENTER RD STE D20
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2967
Practice Address - Country:US
Practice Address - Phone:216-544-4156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1801461101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health