Provider Demographics
NPI:1174769004
Name:BRODY, HEIDI (LCSW-R)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:
Last Name:BRODY
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 N BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-2553
Mailing Address - Country:US
Mailing Address - Phone:914-222-1026
Mailing Address - Fax:
Practice Address - Street 1:118 N BEDFORD RD
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2553
Practice Address - Country:US
Practice Address - Phone:914-222-1026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-24
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR073556-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical