Healthcare Provider Details

I. General information

NPI: 1689759110
Provider Name (Legal Business Name): MARK HIRSCHFELD LCSW-C, BCD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11102 VEIRS MILL ROAD SUITE # 707
WHEATON MD
20902
US

IV. Provider business mailing address

305 PRELUDE DR
SILVER SPRING MD
20901-5041
US

V. Phone/Fax

Practice location:
  • Phone: 301-933-6182
  • Fax: 301-681-0331
Mailing address:
  • Phone: 301-933-6182
  • Fax: 301-681-0331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number02603
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: