Provider Demographics
NPI:1376795641
Name:JAMES-FRIEDMAN, JACQUELINE SHARON (MS LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:SHARON
Last Name:JAMES-FRIEDMAN
Suffix:
Gender:F
Credentials:MS LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18612 VAN METER PL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-4158
Mailing Address - Country:US
Mailing Address - Phone:925-528-9965
Mailing Address - Fax:
Practice Address - Street 1:5806 MESA DR STE 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3783
Practice Address - Country:US
Practice Address - Phone:512-201-4006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI184101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health