Provider Demographics
NPI:1568619070
Name:FRIEDMAN, DAVID (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11835 METROPOLITAN AVE
Mailing Address - Street 2:APT.. B4
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-2069
Mailing Address - Country:US
Mailing Address - Phone:212-749-8237
Mailing Address - Fax:
Practice Address - Street 1:11835 METROPOLITAN AVE
Practice Address - Street 2:APT.. B4
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-2069
Practice Address - Country:US
Practice Address - Phone:212-749-8237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR046525-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health