Provider Demographics
NPI:1003420530
Name:ORDANEZ, HAZEL BORREGO (LCSW)
Entity Type:Individual
Prefix:MS
First Name:HAZEL
Middle Name:BORREGO
Last Name:ORDANEZ
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 1:943 WILLOUGHBY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-2619
Mailing Address - Country:US
Mailing Address - Phone:646-234-3916
Mailing Address - Fax:
Practice Address - Street 1:545 E 142ND ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-2110
Practice Address - Country:US
Practice Address - Phone:718-575-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0775001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical