Provider Demographics
NPI:1588324362
Name:HIRSH, MAX SAMUEL (MSW)
Entity type:Individual
Prefix:MR
First Name:MAX
Middle Name:SAMUEL
Last Name:HIRSH
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4162 TERRACE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-5012
Mailing Address - Country:US
Mailing Address - Phone:717-648-7888
Mailing Address - Fax:
Practice Address - Street 1:1501 LOWER STATE RD STE 200
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-1216
Practice Address - Country:US
Practice Address - Phone:215-343-8987
Practice Address - Fax:215-343-8983
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty