Provider Demographics
NPI:1770967960
Name:FRIEDMAN, MICHAEL (LCSW-C)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8932 TOWN AND COUNTRY BLVD APT E
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-3121
Mailing Address - Country:US
Mailing Address - Phone:410-465-1785
Mailing Address - Fax:443-388-9535
Practice Address - Street 1:2112 MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-5624
Practice Address - Country:US
Practice Address - Phone:443-388-9530
Practice Address - Fax:443-388-9535
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD060471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical