Provider Demographics
NPI:1154870285
Name:FREID, CATHRYN (PHD)
Entity type:Individual
Prefix:DR
First Name:CATHRYN
Middle Name:
Last Name:FREID
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 LINCOLN ST
Mailing Address - Street 2:SUITE 3A, OFFICE 1
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02461-1552
Mailing Address - Country:US
Mailing Address - Phone:617-862-0766
Mailing Address - Fax:
Practice Address - Street 1:17 LINCOLN ST
Practice Address - Street 2:SUITE 3A, OFFICE 1
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02461-1552
Practice Address - Country:US
Practice Address - Phone:617-862-0766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10332103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical