Provider Demographics
NPI:1720501471
Name:FRIEDLANDER, ADAM GABRIEL (BCBA)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:GABRIEL
Last Name:FRIEDLANDER
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1277 NESBITT DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-1765
Mailing Address - Country:US
Mailing Address - Phone:678-677-3598
Mailing Address - Fax:
Practice Address - Street 1:4225 PORTSMOUTH BLVD STE B
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-2154
Practice Address - Country:US
Practice Address - Phone:757-292-4774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133001495103K00000X
VA1-17-26312103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst