Provider Demographics
NPI:1760837785
Name:KATHLEEN M. FRIEND LMFT LLC
Entity Type:Organization
Organization Name:KATHLEEN M. FRIEND LMFT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:FRIEND
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-951-6723
Mailing Address - Street 1:1 CHURCH WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-3573
Mailing Address - Country:US
Mailing Address - Phone:860-951-6723
Mailing Address - Fax:
Practice Address - Street 1:1 CHURCH WAY
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-3573
Practice Address - Country:US
Practice Address - Phone:860-951-6723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001704251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health