Provider Demographics
NPI:1366574758
Name:BIRNBAUM, NORBERT (LCSW)
Entity type:Individual
Prefix:MR
First Name:NORBERT
Middle Name:
Last Name:BIRNBAUM
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 OCEAN BAY DR APT 404
Mailing Address - Street 2:
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-4286
Mailing Address - Country:US
Mailing Address - Phone:305-451-4095
Mailing Address - Fax:305-453-1270
Practice Address - Street 1:1530 OCEAN BAY DR APT 404
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-4286
Practice Address - Country:US
Practice Address - Phone:305-451-4095
Practice Address - Fax:305-453-1270
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW68771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical