Provider Demographics
NPI:1023337953
Name:FRIEDMAN, TINA (LMHC)
Entity type:Individual
Prefix:MS
First Name:TINA
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8695 COLLEGE PKWY
Mailing Address - Street 2:2258
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-4890
Mailing Address - Country:US
Mailing Address - Phone:239-489-4705
Mailing Address - Fax:239-489-2732
Practice Address - Street 1:8695 COLLEGE PKWY
Practice Address - Street 2:2258
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-4890
Practice Address - Country:US
Practice Address - Phone:239-489-4705
Practice Address - Fax:239-489-2732
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6989101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health