MEDICARE: MICHAEL C FRIEDMAN MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	RC00059911	WA
2	101YM0800X	Mental Health Counselor	LH60746917	WA

General Provider Information

NPI Number	:	1205071438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL C FRIEDMAN MA

Provider Business Mailing Address
First Line	:	74-855 IWALANI PL
Second Line	:
City	:	KAILUA KONA
State	:	HI
Zip	:	96740-9650
Country	:	US
Telephone Number	:	503-753-9938
Fax Number	:

Provider Business Practice Location Address
First Line	:	73-5618 MAIAU ST STE B201
Second Line	:
City	:	KAILUA KONA
State	:	HI
Zip	:	96740-2635
Country	:	US
Telephone Number	:	503-753-9938
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2008
Last Update Date	:	03/03/2022

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