Provider Demographics
NPI:1134439219
Name:FRIEDMAN, GUS F (LPC)
Entity type:Individual
Prefix:MR
First Name:GUS
Middle Name:F
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9114 E LAKE HIGHLANDS DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-2774
Mailing Address - Country:US
Mailing Address - Phone:214-529-1299
Mailing Address - Fax:
Practice Address - Street 1:1120 RANDLETT ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-1600
Practice Address - Country:US
Practice Address - Phone:972-227-0190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63683101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional