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General NPI Number Information
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NPI Number | 1922368604
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Entity Type | Individual
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Provider Name | WAYNE S. FRIEDEN M.ED., CAGS, LMHC
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Gender | Male
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Dates
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Enumeration Date | 05/29/2012
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Last Update Date | 05/29/2012
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Provider Practice Location Address
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Address Line | 175 DERBY ST STE 2
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City | HINGHAM
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State | MA
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Zip | 02043-4035
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Country | US
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Telephone | 781-749-9227
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Fax |
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Provider Business Mailing Address
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Address Line | 60 DRACUT ST # 1
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City | DORCHESTER
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State | MA
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Zip | 02124-3807
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Country | US
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Telephone | 617-909-7122
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1719
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 358
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License Number State | MA
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