Provider Demographics
NPI:1346647591
Name:LINDENBLATT, TIRTZA (LCSW, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:TIRTZA
Middle Name:
Last Name:LINDENBLATT
Suffix:
Gender:F
Credentials:LCSW, BCBA, LBA
Other - Prefix:
Other - First Name:TIRZA
Other - Middle Name:
Other - Last Name:LINDENBLATT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:341 TRINITY PL
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-1234
Mailing Address - Country:US
Mailing Address - Phone:516-229-1194
Mailing Address - Fax:516-329-9747
Practice Address - Street 1:572 PALM LN
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-3024
Practice Address - Country:US
Practice Address - Phone:516-229-1194
Practice Address - Fax:212-731-0213
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-02
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070346104100000X
NY000494103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker