Provider Demographics
NPI:1255046041
Name:HIRTH, BRENDA F (LMSW)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:F
Last Name:HIRTH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 BURTON AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1748
Mailing Address - Country:US
Mailing Address - Phone:516-835-5321
Mailing Address - Fax:
Practice Address - Street 1:46 BURTON AVE
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1748
Practice Address - Country:US
Practice Address - Phone:516-835-5321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088933-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker