Provider Demographics
NPI:1891874236
Name:HENNEDY-FRIEL, ELIZABETH JANE (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JANE
Last Name:HENNEDY-FRIEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 OCEANVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9555
Mailing Address - Country:US
Mailing Address - Phone:207-283-3651
Mailing Address - Fax:
Practice Address - Street 1:890 PORTLAND RD
Practice Address - Street 2:SUITE 6
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-9600
Practice Address - Country:US
Practice Address - Phone:207-284-2145
Practice Address - Fax:207-284-6025
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC29221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical