Provider Demographics
NPI:1699916809
Name:KIRSCHNER, MICHELE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:
Last Name:KIRSCHNER
Suffix:
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 1:15231 JEWEL AVE
Mailing Address - Street 2:APT 2R
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1435
Mailing Address - Country:US
Mailing Address - Phone:718-785-3758
Mailing Address - Fax:
Practice Address - Street 1:9745 QUEENS BLVD
Practice Address - Street 2:SUITE 900
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2116
Practice Address - Country:US
Practice Address - Phone:718-830-2435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078124-1104100000X
NY12203671041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool