Healthcare Provider Details

I. General information

NPI: 1134470396
Provider Name (Legal Business Name): LYNN VALARIE FRIEDMAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2012
Last Update Date: 08/06/2022
Certification Date: 08/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5110 LAWTON DR
BETHESDA MD
20816-1941
US

IV. Provider business mailing address

5110 LAWTON DR
BETHESDA MD
20816-1941
US

V. Phone/Fax

Practice location:
  • Phone: 240-483-3530
  • Fax:
Mailing address:
  • Phone: 240-483-3530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number03349
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License NumberPSY1000015
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number03349
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number03349
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number03349
License Number StateMD
# 6
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY1000015
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: