Doctor Name: | MR. KEITH L HERBERT |
NPI Number: | 1679644140 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | R024623-1 |
Business Practice Address: | 49 Main St Rosendale, NY - 12472 |
Business Phone Number: | 8456589760 |
Business Fax Number: | |
Mailing Address: | 151 Alda Dr, KINGSTON |
State: | NY |
Postal Code: | 124018702 |
Phone Number: | 8453391020 |
Fax Number: | 8453392370 |
NPI Enumeration Date: | 11/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | R024623-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |