Provider Demographics
NPI:1952063125
Name:HAIN, ANTHONY (LICSW)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:HAIN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 CHAMPLAIN ST NW APT 31
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-8611
Mailing Address - Country:US
Mailing Address - Phone:202-415-8669
Mailing Address - Fax:
Practice Address - Street 1:1555 CONNECTICUT AVE NW STE 400E
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1124
Practice Address - Country:US
Practice Address - Phone:202-356-3952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC2000014151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical