Provider Demographics
NPI:1801965801
Name:SPIRO, MIRIAM RENA (JD, CSW)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:RENA
Last Name:SPIRO
Suffix:
Gender:F
Credentials:JD, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 E 12TH ST APT 7B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4477
Mailing Address - Country:US
Mailing Address - Phone:917-972-8313
Mailing Address - Fax:
Practice Address - Street 1:26 EAST 9TH ST.
Practice Address - Street 2:SUITE 7D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:212-529-5440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY065740-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical