Provider Demographics
NPI:1073654711
Name:HASTINGS, DACIA P (MSW, LICSW, LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:DACIA
Middle Name:P
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:MSW, LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4113 MEADE ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-1949
Mailing Address - Country:US
Mailing Address - Phone:202-399-0005
Mailing Address - Fax:202-399-7273
Practice Address - Street 1:4113 MEADE ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-1949
Practice Address - Country:US
Practice Address - Phone:202-399-0005
Practice Address - Fax:202-399-7273
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC30008321041C0700X
MD126071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC246944OtherPROVIDER # FOR COMPSYCH