Provider Demographics
NPI:1972625143
Name:FRIDMAN, PATRICIA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:FRIDMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 GIBSON RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-1736
Mailing Address - Country:US
Mailing Address - Phone:248-425-8981
Mailing Address - Fax:
Practice Address - Street 1:5600 W MAPLE RD STE B212
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3787
Practice Address - Country:US
Practice Address - Phone:248-425-8981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801068088104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N56250Medicare ID - Type Unspecified