Provider Demographics
NPI:1114256823
Name:HADDAD, HEIDI (LCSW)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:HADDAD
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 1:1182 BROADWAY
Mailing Address - Street 2:STE 3A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5403
Mailing Address - Country:US
Mailing Address - Phone:212-889-1603
Mailing Address - Fax:
Practice Address - Street 1:1182 BROADWAY
Practice Address - Street 2:STE 3A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5403
Practice Address - Country:US
Practice Address - Phone:212-889-1603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-09
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical