Healthcare Provider Details

I. General information

NPI: 1639727233
Provider Name (Legal Business Name): KATHLEEN KAYLEE FRIEDMAN PHD, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLEE FRIEDMAN PHD, LPC

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 NASSAU ST
PRINCETON NJ
08540-4646
US

IV. Provider business mailing address

3133 SCOTTYS TER
SIMI VALLEY CA
93063-1010
US

V. Phone/Fax

Practice location:
  • Phone: 609-436-0375
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00490800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: