Provider Demographics
NPI:1336701945
Name:FREID, YITZCHOK ARYEH (LCSW, CASAC-T)
Entity type:Individual
Prefix:
First Name:YITZCHOK
Middle Name:ARYEH
Last Name:FREID
Suffix:
Gender:M
Credentials:LCSW, CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 TOUHY AVE STE 404
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3253
Mailing Address - Country:US
Mailing Address - Phone:847-329-9210
Mailing Address - Fax:773-347-2656
Practice Address - Street 1:5550 TOUHY AVE STE 404
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3253
Practice Address - Country:US
Practice Address - Phone:847-329-9210
Practice Address - Fax:773-347-2656
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0229161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical