Provider Demographics
NPI:1013097807
Name:FRYDLEWICZ, KATRINA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:
Last Name:FRYDLEWICZ
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 1:400 BROAD STREET
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446
Mailing Address - Country:US
Mailing Address - Phone:215-368-2022
Mailing Address - Fax:
Practice Address - Street 1:400 N BROAD ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-2414
Practice Address - Country:US
Practice Address - Phone:215-368-2022
Practice Address - Fax:215-855-6454
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW-0151741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical