Healthcare Provider Details

I. General information

NPI: 1629997267
Provider Name (Legal Business Name): WHITNEY FRIEDL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 CHURCH HILL ST
NORRIS SC
29667-9711
US

IV. Provider business mailing address

117 CHURCH HILL ST
NORRIS SC
29667-9711
US

V. Phone/Fax

Practice location:
  • Phone: 631-804-6323
  • Fax:
Mailing address:
  • Phone: 631-804-6323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: WHITNEY FRIEDL
Title or Position: BEHAVIOR ANALYST/OWNER
Credential: BCBA
Phone: 631-804-6323