Provider Demographics
NPI:1780338327
Name:CENTER FOR PEDIATRIC AND ADULT ANXIETY AND DEPRESSION PLLC
Entity type:Organization
Organization Name:CENTER FOR PEDIATRIC AND ADULT ANXIETY AND DEPRESSION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST AND DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:610-940-1654
Mailing Address - Street 1:8018 GERMANTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-3421
Mailing Address - Country:US
Mailing Address - Phone:732-996-6375
Mailing Address - Fax:
Practice Address - Street 1:600 W GERMANTOWN PIKE STE 400
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1046
Practice Address - Country:US
Practice Address - Phone:610-940-1654
Practice Address - Fax:610-424-7622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty