Provider Demographics
NPI:1922338417
Name:FRIEDMAN, HEATHER LYNN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LYNN
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30010 N 128TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-3403
Mailing Address - Country:US
Mailing Address - Phone:623-687-8310
Mailing Address - Fax:602-234-2639
Practice Address - Street 1:13460 N 94TH DR
Practice Address - Street 2:K-3
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4835
Practice Address - Country:US
Practice Address - Phone:623-974-3333
Practice Address - Fax:623-974-3390
Is Sole Proprietor?:No
Enumeration Date:2010-01-05
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15144101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional