Provider Demographics
NPI:1437167053
Name:HERSH, MINDY SUSAN (PSY D)
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:SUSAN
Last Name:HERSH
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 BEACH RD
Mailing Address - Street 2:2ND FLOOR, NPBCC
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6668
Mailing Address - Country:US
Mailing Address - Phone:203-292-0082
Mailing Address - Fax:
Practice Address - Street 1:111 BEACH RD
Practice Address - Street 2:2ND FLOOR, NPBCC
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6668
Practice Address - Country:US
Practice Address - Phone:203-292-0082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012884101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health