Individual provider Active NPI

Richard A Brandon-Friedman, PHD, MSW, LCSW, LCAC

  • Clinical Social Worker
  • Greenwood, IN
National Provider Identifier
1669758009
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34006932A Issued in IN
Practice address
390 N Madison Ave
Greenwood, IN 46142-2300
Phone
(602) 750-1541
NPI assigned
Oct 31, 2011
Last updated
Oct 3, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 87000926A IN
Social Worker 104100000X 33006072A IN
Clinical Social Worker 1041C0700X 34006932A IN Primary

Addresses

Primary practice location

390 N Madison Ave
Greenwood, IN 46142-2300

Mailing address

3730 Allen Ave
Fort Wayne, IN 46805-1812
Phone (260) 484-4600

Other names 1

  • Richard Friedman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
87000926AINMDAddiction (Substance Use Disorder) Counselor
33006072AINMDSocial Worker
34006932AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rebecca Waletich LCSW LLC Clinical Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1669758009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3730 ALLEN AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051812",
            "telephone_number": "260-484-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N MADISON AVE",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461422300",
            "telephone_number": "602-750-1541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDON-FRIEDMAN",
        "first_name": "RICHARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD, MSW, LCSW, LCAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-31",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87000926A",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33006072A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006932A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICHARD",
            "last_name": "FRIEDMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.