Provider Demographics
NPI:1578306205
Name:BIRDOFF, REID (LMSW)
Entity type:Individual
Prefix:
First Name:REID
Middle Name:
Last Name:BIRDOFF
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 GREAT NECK RD STE 400N
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3326
Mailing Address - Country:US
Mailing Address - Phone:914-582-4098
Mailing Address - Fax:
Practice Address - Street 1:185 GREAT NECK RD STE 400N
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-3326
Practice Address - Country:US
Practice Address - Phone:914-582-4098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099445104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker