Provider Demographics
NPI:1679236582
Name:HESS, KRISTY (LMSW)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:HESS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 OAK HILL AVE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-3212
Mailing Address - Country:US
Mailing Address - Phone:301-331-9116
Mailing Address - Fax:
Practice Address - Street 1:2850 N RIDGE RD STE 210
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-3463
Practice Address - Country:US
Practice Address - Phone:410-203-1649
Practice Address - Fax:443-288-4676
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25211104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker