Provider Demographics
NPI:1316085673
Name:FRIEDMAN, ADAM DEREK (MS, LMHC)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:DEREK
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUZZARDS BAY
Mailing Address - State:MA
Mailing Address - Zip Code:02532-3229
Mailing Address - Country:US
Mailing Address - Phone:774-836-3738
Mailing Address - Fax:558-590-1219
Practice Address - Street 1:243 MAIN ST
Practice Address - Street 2:
Practice Address - City:BOURNE
Practice Address - State:MA
Practice Address - Zip Code:02532-3234
Practice Address - Country:US
Practice Address - Phone:774-836-3738
Practice Address - Fax:774-836-3738
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6174101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health