Provider Demographics
NPI:1083690788
Name:HOOVER, JAMES C (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:HOOVER
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 S COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5954
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 SETON DR
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1854
Practice Address - Country:US
Practice Address - Phone:301-723-1443
Practice Address - Fax:301-723-1480
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD075091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD547531 05 07OtherCAREFIRST BC BS
DCM093 0013OtherBLUE CHOICE BC BS
MD425083OtherMAMSI
MDKN31SEOtherCAREFIRST BC BS
MDP00201924Medicare ID - Type UnspecifiedTRAVELERS MEDICARE