Provider Demographics
NPI:1790553923
Name:FRIEDMAN, KIRSTEN LEE (CSW)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:LEE
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 GARDEN OF THE GODS RD STE 188
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-4246
Mailing Address - Country:US
Mailing Address - Phone:719-350-3739
Mailing Address - Fax:719-888-1896
Practice Address - Street 1:300 GARDEN OF THE GODS RD STE 188
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-4246
Practice Address - Country:US
Practice Address - Phone:719-350-3739
Practice Address - Fax:719-888-1896
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO099301821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical