Provider Demographics
NPI:1548212996
Name:HIMMELBAUM, HENRY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:
Last Name:HIMMELBAUM
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:HENRY
Other - Middle Name:NMN
Other - Last Name:HIMMELBAUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:666 MONACO COURT, BLDG N
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-1949
Mailing Address - Country:US
Mailing Address - Phone:561-716-4840
Mailing Address - Fax:954-431-0413
Practice Address - Street 1:666 MONACO COURT, BLDG N
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-1949
Practice Address - Country:US
Practice Address - Phone:561-716-4840
Practice Address - Fax:954-431-0413
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 32031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical