Provider Demographics
NPI:1831326347
Name:HERSKOVITS, MERYL COHEN (LCSW)
Entity type:Individual
Prefix:
First Name:MERYL
Middle Name:COHEN
Last Name:HERSKOVITS
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 1:101 S FORT LAUDERDALE BEACH BLVD
Mailing Address - Street 2:1403
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1559
Mailing Address - Country:US
Mailing Address - Phone:954-937-7328
Mailing Address - Fax:
Practice Address - Street 1:1531 W PALMETTO PARK RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-3307
Practice Address - Country:US
Practice Address - Phone:561-395-5031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW43331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical