MEDICARE: MRS. SUSAN E. FRIEDENBERGER L.P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PC002664	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001467901	OTHER	PA	HIGHMARK

General Provider Information

NPI Number	:	1033185723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN E. FRIEDENBERGER L.P.C.

Provider Business Mailing Address
First Line	:	201 CHESTNUT AVE
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16601-4927
Country	:	US
Telephone Number	:	814-946-5411
Fax Number	:	814-940-8471

Provider Business Practice Location Address
First Line	:	400 LAKEMONT PARK BLVD
Second Line	:	SUITE 100
City	:	ALTOONA
State	:	PA
Zip	:	16602-5967
Country	:	US
Telephone Number	:	814-946-5411
Fax Number	:	814-569-1189

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	06/01/2016

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