Provider Demographics
NPI:1629308440
Name:HART, VIRGINIA W (MSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:W
Last Name:HART
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W CHURCH ST
Mailing Address - Street 2:SUITES H AND I
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-7800
Mailing Address - Country:US
Mailing Address - Phone:301-471-0369
Mailing Address - Fax:
Practice Address - Street 1:120 W CHURCH ST
Practice Address - Street 2:SUITES H AND I
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-7800
Practice Address - Country:US
Practice Address - Phone:301-471-0369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-29
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD071251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical