Provider Demographics
NPI:1003021049
Name:HERTZ, CLAIRE M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:M
Last Name:HERTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 W END AVE
Mailing Address - Street 2:1S
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6103
Mailing Address - Country:US
Mailing Address - Phone:212-877-3365
Mailing Address - Fax:
Practice Address - Street 1:142 W END AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6103
Practice Address - Country:US
Practice Address - Phone:212-877-3365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR6154102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst