Provider Demographics
NPI:1457410870
Name:HIRSCHFELD, TERRY LEE (MSW)
Entity Type:Individual
Prefix:MS
First Name:TERRY
Middle Name:LEE
Last Name:HIRSCHFELD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 RIDGEWAY AVE
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-1334
Mailing Address - Country:US
Mailing Address - Phone:859-441-8889
Mailing Address - Fax:859-781-7169
Practice Address - Street 1:26 AUDUBON PL
Practice Address - Street 2:
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075-1920
Practice Address - Country:US
Practice Address - Phone:859-781-5719
Practice Address - Fax:859-781-7169
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYLCSW17731041C0700X
OHI72091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYCSW0301Medicare ID - Type Unspecified