Provider Demographics
NPI:1831317114
Name:FRIED, AMNON K (LCSW)
Entity type:Individual
Prefix:MR
First Name:AMNON
Middle Name:K
Last Name:FRIED
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 SINGLETON ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-1138
Mailing Address - Country:US
Mailing Address - Phone:919-851-6979
Mailing Address - Fax:
Practice Address - Street 1:217 SINGLETON ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-1138
Practice Address - Country:US
Practice Address - Phone:919-851-6979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0026571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical