Provider Demographics
NPI:1013075860
Name:HERSKOVITS, SHARONA R (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHARONA
Middle Name:R
Last Name:HERSKOVITS
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 1:1333 E 18TH ST
Mailing Address - Street 2:APT 4A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-7555
Mailing Address - Country:US
Mailing Address - Phone:347-713-5734
Mailing Address - Fax:
Practice Address - Street 1:250 WEST 57TH STREET
Practice Address - Street 2:STE 501
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:917-445-8580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075190-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical