Provider Demographics
NPI:1144305897
Name:FRIEDMAN, HEIDI (LPC,LMFT)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:LPC,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6312 ADIRONDACK CT
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-6630
Mailing Address - Country:US
Mailing Address - Phone:703-586-3597
Mailing Address - Fax:
Practice Address - Street 1:8140 ASHTON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-5698
Practice Address - Country:US
Practice Address - Phone:703-586-3597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717000325106H00000X
VA0701001764101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004978277Medicaid
VA210245OtherBLUE CROSS BLUE SHIELD
VA004945247Medicaid
VA546001531OtherEIN