Provider Demographics
NPI:1093369159
Name:AMANDA HIRSCH-GEFFNER
Entity Type:Organization
Organization Name:AMANDA HIRSCH-GEFFNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HIRSCH GEFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-439-7405
Mailing Address - Street 1:102 FAWN DR
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-2723
Mailing Address - Country:US
Mailing Address - Phone:917-439-7405
Mailing Address - Fax:
Practice Address - Street 1:1372 SUMMER ST RM 205
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5365
Practice Address - Country:US
Practice Address - Phone:917-439-7405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-27
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty