Provider Demographics
NPI:1649559121
Name:HERTZLER, BROOKE ALISON (LCSW)
Entity type:Individual
Prefix:MISS
First Name:BROOKE
Middle Name:ALISON
Last Name:HERTZLER
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 1:5800 CORPORATE DR STE 312
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-7098
Mailing Address - Country:US
Mailing Address - Phone:717-580-4797
Mailing Address - Fax:
Practice Address - Street 1:5800 CORPORATE DR STE 312
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-7098
Practice Address - Country:US
Practice Address - Phone:412-748-1707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0160941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical