Provider Demographics
NPI:1013951144
Name:HIRSCH, RICHARD BRYAN (LSW)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:BRYAN
Last Name:HIRSCH
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 W RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:PA
Mailing Address - Zip Code:17078-8539
Mailing Address - Country:US
Mailing Address - Phone:717-838-5525
Mailing Address - Fax:570-322-8026
Practice Address - Street 1:960 CENTURY DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-4374
Practice Address - Country:US
Practice Address - Phone:717-795-0330
Practice Address - Fax:717-795-0407
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW011710L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA03268901OtherCAPITAL BLUE CROSS