Provider Demographics
NPI:1386034361
Name:HERZENBERG-KLEINMAN, SONIA (LCSW)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:HERZENBERG-KLEINMAN
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 1:12 N 7TH AVE
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-2026
Mailing Address - Country:US
Mailing Address - Phone:914-361-6511
Mailing Address - Fax:914-699-5963
Practice Address - Street 1:12 N 7TH AVE
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2026
Practice Address - Country:US
Practice Address - Phone:914-361-6511
Practice Address - Fax:914-699-5963
Is Sole Proprietor?:No
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0769251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical