Provider Demographics
NPI:1134423791
Name:HARTRANFT, JESSICA (LCSWC)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:HARTRANFT
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1413 PARK AVE
Mailing Address - Street 2:2F
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-4282
Mailing Address - Country:US
Mailing Address - Phone:443-745-4804
Mailing Address - Fax:
Practice Address - Street 1:1413 PARK AVE
Practice Address - Street 2:2F
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-4282
Practice Address - Country:US
Practice Address - Phone:443-745-4804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-22
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD152151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical