1861522146 NPI number — MRS. HELENA R FRIEDMAN ACSW

Table of content: MRS. HELENA R FRIEDMAN ACSW (NPI 1861522146)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861522146 NPI number — MRS. HELENA R FRIEDMAN ACSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRIEDMAN
Provider First Name:
HELENA
Provider Middle Name:
R
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ACSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861522146
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8715 NW 75TH PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMARAC
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33321-2445
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-722-3568
Provider Business Mailing Address Fax Number:
954-722-0363

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8715 NW 75TH PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAMARAC
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33321-2445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-722-3568
Provider Business Practice Location Address Fax Number:
954-722-0363
Provider Enumeration Date:
03/06/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LCSWRO280391 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0036630 . This is a "GHI PROVIDER NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".