Provider Demographics
NPI:1619426137
Name:HAGER, MARIBETH HILLIARD (LICSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:MARIBETH
Middle Name:HILLIARD
Last Name:HAGER
Suffix:
Gender:F
Credentials:LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5713 BREWER HOUSE CIR APT T2
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-5430
Mailing Address - Country:US
Mailing Address - Phone:301-503-5156
Mailing Address - Fax:
Practice Address - Street 1:5402 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 102
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2857
Practice Address - Country:US
Practice Address - Phone:301-503-5156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3036161041C0700X
MD112061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical