Provider Demographics
NPI:1407116387
Name:THOMAS D. FRIEDRICHS PH.D. P.C.
Entity Type:Organization
Organization Name:THOMAS D. FRIEDRICHS PH.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:FRIEDRICHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-257-9991
Mailing Address - Street 1:5605 GLENRIDGE DR NE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1365
Mailing Address - Country:US
Mailing Address - Phone:404-257-9991
Mailing Address - Fax:404-257-0299
Practice Address - Street 1:5605 GLENRIDGE DR NE
Practice Address - Street 2:SUITE 600
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1365
Practice Address - Country:US
Practice Address - Phone:404-257-9991
Practice Address - Fax:404-257-0299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY000327103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty