1366973190 NPI number — MR. CHRISTOPHER FRIEDRICH MA, LPC

Table of content: MR. CHRISTOPHER FRIEDRICH MA, LPC (NPI 1366973190)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366973190 NPI number — MR. CHRISTOPHER FRIEDRICH MA, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRIEDRICH
Provider First Name:
CHRISTOPHER
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MA, LPC
Provider Gender Code:
M

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:
1366973190
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/23/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
191 WOODPORT RD
Provider Second Line Business Mailing Address:
SUITE 209
Provider Business Mailing Address City Name:
SPARTA
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07871-2607
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-512-3700
Provider Business Mailing Address Fax Number:
973-512-3701

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
191 WOODPORT RD
Provider Second Line Business Practice Location Address:
SUITE 209
Provider Business Practice Location Address City Name:
SPARTA
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07871-2607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-512-3700
Provider Business Practice Location Address Fax Number:
973-512-3701
Provider Enumeration Date:
03/23/2017

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: 101YM0800X , with the licence number:  37PC00536600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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