Provider Demographics
NPI:1689352940
Name:HIRSHON, REBECCA MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARIE
Last Name:HIRSHON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KAI
Other - Middle Name:ZIRA
Other - Last Name:HIRSHON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:15250 SIESTA KEY WAY APT 156
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5545
Mailing Address - Country:US
Mailing Address - Phone:443-458-8341
Mailing Address - Fax:
Practice Address - Street 1:30 GREENWAY ST NW STE 5
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3557
Practice Address - Country:US
Practice Address - Phone:410-760-9079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30214104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker