Provider Demographics
NPI:1902108301
Name:FRIEDLANDER, GRETCHEN B (LPC)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:B
Last Name:FRIEDLANDER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 E MARYLAND AVE
Mailing Address - Street 2:B-104
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-1469
Mailing Address - Country:US
Mailing Address - Phone:602-614-8004
Mailing Address - Fax:
Practice Address - Street 1:1536 E MARYLAND AVE
Practice Address - Street 2:SUITE B-104
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-1469
Practice Address - Country:US
Practice Address - Phone:602-614-8004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-12989101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional