Provider Demographics
NPI:1114244829
Name:HARDESTY, ANN-LOUISE (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:ANN-LOUISE
Middle Name:
Last Name:HARDESTY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:LOUISE
Other - Last Name:BOYCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:1716 HARFORD ROAD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047
Mailing Address - Country:US
Mailing Address - Phone:410-877-7207
Mailing Address - Fax:410-877-7224
Practice Address - Street 1:1716 HARFORD ROAD SUITE 204
Practice Address - Street 2:KILGALEN ASSOCIATES
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047
Practice Address - Country:US
Practice Address - Phone:410-877-7207
Practice Address - Fax:410-877-7224
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD137971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical