MEDICARE: NESHAMA J FRIEND LCSW

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	1041C0700X	Clinical Social Worker	SW4332	FL

General Provider Information

NPI Number	:	1932180395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NESHAMA J FRIEND LCSW

Provider Business Mailing Address
First Line	:	9184 GREEN MEADOWS WAY
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-5744
Country	:	US
Telephone Number	:	561-313-4369
Fax Number	:	561-828-9272

Provider Business Practice Location Address
First Line	:	9184 GREEN MEADOWS WAY
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-5744
Country	:	US
Telephone Number	:	561-313-4369
Fax Number	:

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

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	07/25/2024

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