Provider Demographics
NPI:1285088088
Name:FRIEND, KATHLEEN (LMFT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:FRIEND
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHURCH WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-3573
Mailing Address - Country:US
Mailing Address - Phone:860-951-6723
Mailing Address - Fax:860-371-2454
Practice Address - Street 1:1 CONGRESS ST STE 210
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06114-1067
Practice Address - Country:US
Practice Address - Phone:860-951-6723
Practice Address - Fax:860-288-2882
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001704106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist