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General NPI Number Information
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NPI Number | 1689939670
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Entity Type | Individual
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Provider Name | COREY HIRSCH LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/06/2012
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 5275 COLODNY DR AGOURA HILLS
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City | AGOURA HILLS
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State | CA
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Zip | 91301
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Country | US
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Telephone | 310-486-8842
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Fax |
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Provider Business Mailing Address
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Address Line | 5627 KANAN RD # 108
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City | AGOURA
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State | CA
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Zip | 91301-3358
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Country | US
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Telephone | 310-486-8842
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Fax | 818-914-4253
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 74253
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License Number State | CA
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