Provider Demographics
NPI:1821001991
Name:HESS, CHRISTINE CAROL (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:CAROL
Last Name:HESS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2595 PURNELL DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-6161
Mailing Address - Country:US
Mailing Address - Phone:443-691-1499
Mailing Address - Fax:
Practice Address - Street 1:1447 YORK RD STE 506
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6022
Practice Address - Country:US
Practice Address - Phone:410-825-2281
Practice Address - Fax:410-825-2280
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD104231041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD991402100Medicaid