Provider Demographics
NPI:1497508618
Name:HAZZARD, JAMES (LMSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HAZZARD
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 FRANKLIN AVE STE 403
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-1263
Mailing Address - Country:US
Mailing Address - Phone:410-973-2211
Mailing Address - Fax:443-782-0350
Practice Address - Street 1:30265 COMMERCE DR UNIT 205
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-3595
Practice Address - Country:US
Practice Address - Phone:302-245-8722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ3-0010810104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker