Provider Demographics
NPI:1881707917
Name:GOODFRIEND, HERBERT (LCSW LCADC)
Entity type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:
Last Name:GOODFRIEND
Suffix:
Gender:M
Credentials:LCSW LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 MURRAY ST
Mailing Address - Street 2:APT. 5
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-1909
Mailing Address - Country:US
Mailing Address - Phone:908-351-6080
Mailing Address - Fax:
Practice Address - Street 1:24 ELM ST
Practice Address - Street 2:SUITE 6
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-8802
Practice Address - Country:US
Practice Address - Phone:908-351-6080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00048900101YA0400X
NJ44SC010158001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
025963Medicare ID - Type Unspecified