Provider Demographics
NPI:1144387911
Name:KOPMAN-FRIED, JUDY ROBIN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:ROBIN
Last Name:KOPMAN-FRIED
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 1:950 YALE AVE
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-1858
Mailing Address - Country:US
Mailing Address - Phone:203-269-3488
Mailing Address - Fax:203-272-6163
Practice Address - Street 1:950 YALE AVE
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-1858
Practice Address - Country:US
Practice Address - Phone:203-269-3488
Practice Address - Fax:203-272-6163
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0005791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical