Provider Demographics
NPI:1225464639
Name:HANSHEW, FAITH RENEE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:FAITH
Middle Name:RENEE
Last Name:HANSHEW
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 TALL OAK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-5319
Mailing Address - Country:US
Mailing Address - Phone:240-385-7000
Mailing Address - Fax:
Practice Address - Street 1:42 TALL OAK DR
Practice Address - Street 2:
Practice Address - City:CHARLES TOWN
Practice Address - State:WV
Practice Address - Zip Code:25414-5319
Practice Address - Country:US
Practice Address - Phone:240-385-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-17
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP009443181041C0700X
WVBP00944318104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty