Provider Demographics
NPI:1073002002
Name:HEARN, ALLEN (LCSW)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:
Last Name:HEARN
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 1:2490 EASTSHORE PL UNIT 505
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-0024
Mailing Address - Country:US
Mailing Address - Phone:269-718-1326
Mailing Address - Fax:
Practice Address - Street 1:2490 EASTSHORE PL UNIT 505
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-0024
Practice Address - Country:US
Practice Address - Phone:269-718-1326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010913091041C0700X
NV7310-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical