Provider Demographics
NPI:1790819860
Name:BRICKMAN, HAL (HAL BRICKMAN)
Entity Type:Individual
Prefix:MR
First Name:HAL
Middle Name:
Last Name:BRICKMAN
Suffix:
Gender:M
Credentials:HAL BRICKMAN
Other - Prefix:
Other - First Name:HAL
Other - Middle Name:
Other - Last Name:BRICKMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:23 LINWOOD RD S
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1413
Mailing Address - Country:US
Mailing Address - Phone:516-570-0647
Mailing Address - Fax:
Practice Address - Street 1:23 LINWOOD RD S
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-1413
Practice Address - Country:US
Practice Address - Phone:516-570-0647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical