Provider Demographics
NPI:1881213189
Name:HEARST, MARKIA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARKIA
Middle Name:
Last Name:HEARST
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARKIA
Other - Middle Name:
Other - Last Name:RANDLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3420 ARKLOW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-0778
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3420 ARKLOW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0778
Practice Address - Country:US
Practice Address - Phone:704-951-4859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0113241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical