Provider Demographics
NPI:1780130997
Name:FRIEDMAN, AMANDA (MS LPCC-S)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:MS LPCC-S
Other - Prefix:
Other - First Name:MANDY
Other - Middle Name:
Other - Last Name:FRIEDMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS LPCC-S
Mailing Address - Street 1:431 OHIO PIKE STE 103N
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3372
Mailing Address - Country:US
Mailing Address - Phone:513-655-6911
Mailing Address - Fax:
Practice Address - Street 1:431 OHIO PIKE STE 103N
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3372
Practice Address - Country:US
Practice Address - Phone:513-655-6911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1700191-SUPV101YP2500X
OHC.2204064101YP2500X
OHC.1600468101YP2500X
OHI.21032411041C0700X
OHS.15002411041C0700X
OHE.1800953-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty