Provider Demographics
NPI:1194412015
Name:FRIED, NICOLE E (LPC)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:E
Last Name:FRIED
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 1:564 LEE CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-2520
Mailing Address - Country:US
Mailing Address - Phone:973-820-6257
Mailing Address - Fax:
Practice Address - Street 1:4 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5237
Practice Address - Country:US
Practice Address - Phone:201-588-3491
Practice Address - Fax:201-357-4222
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00924300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty