Provider Demographics
NPI:1316223696
Name:HERSCH, JAMIE (LMSW)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:HERSCH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E 86TH ST APT 22E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-3076
Mailing Address - Country:US
Mailing Address - Phone:516-220-0926
Mailing Address - Fax:
Practice Address - Street 1:292 MADISON AVE FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6323
Practice Address - Country:US
Practice Address - Phone:212-418-0335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
081987-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker