Provider Demographics
NPI:1467607838
Name:FRIEDMAN, AMY LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:FRIEDMAN
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 1:608 W HORATIO ST STE B
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-4104
Mailing Address - Country:US
Mailing Address - Phone:813-601-2494
Mailing Address - Fax:
Practice Address - Street 1:608 W HORATIO ST STE B
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-4104
Practice Address - Country:US
Practice Address - Phone:813-601-2494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW76821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical