Provider Demographics
NPI:1285778647
Name:FRIDMAN, EFRAT SHOSHANA (LCSW)
Entity type:Individual
Prefix:
First Name:EFRAT
Middle Name:SHOSHANA
Last Name:FRIDMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PINETREE LN
Mailing Address - Street 2:
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568-1118
Mailing Address - Country:US
Mailing Address - Phone:516-224-7670
Mailing Address - Fax:866-514-8855
Practice Address - Street 1:2 PINETREE LN
Practice Address - Street 2:
Practice Address - City:OLD WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11568-1118
Practice Address - Country:US
Practice Address - Phone:516-224-7670
Practice Address - Fax:866-514-8855
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0802731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical