Joel B Freid PHD PA

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY 0002213 Issued in FL

Legal business name

JOEL B FREID PHD PA

Practice address

2020 W Lake Parker Dr
Lakeland, FL 33805-5005

Phone

(863) 682-7580

Fax

(863) 683-9564

NPI assigned

Dec 27, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Joel Benjamin Freid, PH.D.

Title

President

Phone

(863) 644-0506

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609931955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 IMPERIAL PKWY",
            "address_2": "SUITE 128",
            "city": "MULBERRY",
            "state": "FL",
            "postal_code": "338608476",
            "telephone_number": "863-644-0506",
            "fax_number": "863-644-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 W LAKE PARKER DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338055005",
            "telephone_number": "863-682-7580",
            "fax_number": "863-683-9564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOEL B FREID PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FREID",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-644-0506",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 0002213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1346350600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.