Provider Demographics
NPI:1457364127
Name:HEARN-PARKS, JOAN (LCSW)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:HEARN-PARKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COATES DR
Mailing Address - Street 2:SUITE 8
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-6764
Mailing Address - Country:US
Mailing Address - Phone:845-291-0999
Mailing Address - Fax:845-294-8921
Practice Address - Street 1:3 COATES DR
Practice Address - Street 2:SUITE 8
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-6764
Practice Address - Country:US
Practice Address - Phone:845-291-0999
Practice Address - Fax:845-294-8921
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO35968-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker