Provider Demographics
NPI:1255686473
Name:HIRSCH, PAMELA GROFF (LCSW)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:GROFF
Last Name:HIRSCH
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 1:502 ANNE ST
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-2826
Mailing Address - Country:US
Mailing Address - Phone:703-965-3882
Mailing Address - Fax:
Practice Address - Street 1:502 ANNE ST
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-2826
Practice Address - Country:US
Practice Address - Phone:703-965-3882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-14
Last Update Date:2012-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040026201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical