Provider Demographics
NPI:1750666137
Name:ISEN, HIRSCH M (LCSWC)
Entity type:Individual
Prefix:MR
First Name:HIRSCH
Middle Name:M
Last Name:ISEN
Suffix:
Gender:M
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12120 PLUM ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7820
Mailing Address - Country:US
Mailing Address - Phone:301-572-6585
Mailing Address - Fax:301-572-5062
Practice Address - Street 1:12120 PLUM ORCHARD DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7820
Practice Address - Country:US
Practice Address - Phone:301-572-6585
Practice Address - Fax:301-572-5062
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD171211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD17121OtherMD. STATE BOARD OF SOCIAL WORK EXAMINERS