Provider Demographics
NPI:1790866101
Name:FROEHLICH, ROYCE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ROYCE
Middle Name:
Last Name:FROEHLICH
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 1:8526 65TH RD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-5036
Mailing Address - Country:US
Mailing Address - Phone:718-275-0667
Mailing Address - Fax:
Practice Address - Street 1:8524 65TH RD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-5036
Practice Address - Country:US
Practice Address - Phone:718-275-0667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0694991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP2522085OtherOXFORD PROVIDER ID
NYN3O841Medicare ID - Type UnspecifiedPROVIDER ID (MANHATTAN)
NYP2522085OtherOXFORD PROVIDER ID