Provider Demographics
NPI:1174517072
Name:WERFEL, IRMA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:IRMA
Middle Name:
Last Name:WERFEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BETHPAGE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-1515
Mailing Address - Country:US
Mailing Address - Phone:516-935-3334
Mailing Address - Fax:516-674-3556
Practice Address - Street 1:120 BETHPAGE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-1515
Practice Address - Country:US
Practice Address - Phone:516-935-3334
Practice Address - Fax:516-674-3556
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYLCSWR201091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN04901Medicare UPIN