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General NPI Number Information
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NPI Number | 1851442735
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Entity Type | Individual
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Provider Name | MICHAEL FRIEND LICSW
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 25 MARKET ST STE 14
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City | SWANSEA
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State | MA
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Zip | 02777-3998
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Country | US
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Telephone | 401-486-5234
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Fax |
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Provider Business Mailing Address
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Address Line | 68 EARL AVE
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City | RIVERSIDE
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State | RI
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Zip | 02915-3204
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Country | US
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Telephone | 401-486-5234
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ISW01300
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 117090
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License Number State | MA
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