Provider Demographics
NPI:1801015268
Name:FRIED, CAROL S (MSW, LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:S
Last Name:FRIED
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 AMBLER DR
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-4002
Mailing Address - Country:US
Mailing Address - Phone:301-493-5525
Mailing Address - Fax:
Practice Address - Street 1:4207 AMBLER DR
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-4002
Practice Address - Country:US
Practice Address - Phone:301-493-5525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD32011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
716791Medicare ID - Type Unspecified