Provider Demographics
NPI:1629376298
Name:FRIEDMAN, HARRIET G (MA)
Entity Type:Individual
Prefix:MS
First Name:HARRIET
Middle Name:G
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:HARRIET
Other - Middle Name:S
Other - Last Name:GREENFEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:RB&C MAILSTOP 6010
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-368-3057
Practice Address - Fax:216-368-4832
Is Sole Proprietor?:No
Enumeration Date:2011-03-07
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1955103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0283901Medicaid
OHFRCP35481Medicare PIN