Provider Demographics
NPI:1861522146
Name:FRIEDMAN, HELENA R (ACSW)
Entity type:Individual
Prefix:MRS
First Name:HELENA
Middle Name:R
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8715 NW 75TH PL
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2445
Mailing Address - Country:US
Mailing Address - Phone:954-722-3568
Mailing Address - Fax:954-722-0363
Practice Address - Street 1:8715 NW 75TH PL
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2445
Practice Address - Country:US
Practice Address - Phone:954-722-3568
Practice Address - Fax:954-722-0363
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLCSWRO2803911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0036630OtherGHI PROVIDER NUMBER