Provider Demographics
NPI:1346661394
Name:FRIEDMAN, JASON C (PSYD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:C
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9803 BURTON DR
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-3208
Mailing Address - Country:US
Mailing Address - Phone:216-513-5972
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:216-513-5972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7104103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical