Provider Demographics
NPI:1023590205
Name:MFRIEDMAN MHC LLC
Entity type:Organization
Organization Name:MFRIEDMAN MHC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:513-655-6101
Mailing Address - Street 1:431 OHIO PIKE STE 214N
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3629
Mailing Address - Country:US
Mailing Address - Phone:513-655-6911
Mailing Address - Fax:
Practice Address - Street 1:431 OHIO PIKE STE 214N
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3629
Practice Address - Country:US
Practice Address - Phone:513-655-6911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-04
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1740659820Medicaid
OH1427520287Medicaid
OH1639824402Medicaid
OH1760909642Medicaid
OH1780130997Medicaid