Provider Demographics
NPI:1245492479
Name:HARTSOCK, NANCY BURGESS (PSYD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:BURGESS
Last Name:HARTSOCK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12304 QUAIL WOODS DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1542
Mailing Address - Country:US
Mailing Address - Phone:240-328-7924
Mailing Address - Fax:
Practice Address - Street 1:4641 MONTGOMERY AVE 212
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3488
Practice Address - Country:US
Practice Address - Phone:240-328-7924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-29
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4528103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical