Provider Demographics
NPI:1154956340
Name:KIRSCH, PAMELA ANN I (LMSW)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ANN
Last Name:KIRSCH
Suffix:I
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 W 22ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5805
Mailing Address - Country:US
Mailing Address - Phone:917-960-9500
Mailing Address - Fax:
Practice Address - Street 1:34 W 22ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5805
Practice Address - Country:US
Practice Address - Phone:215-206-2631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-08
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097015104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker