Provider Demographics
NPI:1417150723
Name:FRIED, ROBIN E (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:E
Last Name: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 1:320 WEST END AVE
Mailing Address - Street 2:1A
Mailing Address - City:NYC
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:212-580-3538
Mailing Address - Fax:212-724-6090
Practice Address - Street 1:320 WEST END AVE
Practice Address - Street 2:1A
Practice Address - City:NYC
Practice Address - State:NY
Practice Address - Zip Code:10023
Practice Address - Country:US
Practice Address - Phone:212-580-3538
Practice Address - Fax:212-724-6090
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR 0165181104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
N28261Medicare ID - Type Unspecified