Provider Demographics
NPI:1972329548
Name:FAGIN, NACHMA TZIONA (LMSW)
Entity type:Individual
Prefix:MRS
First Name:NACHMA
Middle Name:TZIONA
Last Name:FAGIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:NACHMA
Other - Middle Name:TZIONA
Other - Last Name:HIRSCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:141 WYCKOFF PL APT 2A
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2116
Mailing Address - Country:US
Mailing Address - Phone:516-602-8697
Mailing Address - Fax:
Practice Address - Street 1:112 FRANKLIN PL
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1253
Practice Address - Country:US
Practice Address - Phone:516-374-3671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-28
Last Update Date:2024-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY125207104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker