Provider Demographics
NPI:1306469333
Name:BECCA HIRSCH THERAPY LLC
Entity type:Organization
Organization Name:BECCA HIRSCH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:602-525-6317
Mailing Address - Street 1:1001 N PAULINA ST APT 4
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-3898
Mailing Address - Country:US
Mailing Address - Phone:602-525-6317
Mailing Address - Fax:
Practice Address - Street 1:1001 N PAULINA ST APT 4
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-3898
Practice Address - Country:US
Practice Address - Phone:602-525-6317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)