Provider Demographics
NPI:1225698491
Name:HANFORD FIELDS, ANN KATHRYN (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:KATHRYN
Last Name:HANFORD FIELDS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10319 VERDUGO DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-8155
Mailing Address - Country:US
Mailing Address - Phone:803-250-6509
Mailing Address - Fax:
Practice Address - Street 1:1136 SAM NEWELL RD STE B2
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5166
Practice Address - Country:US
Practice Address - Phone:803-250-6509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-19
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0146521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical