Provider Demographics
NPI:1811355019
Name:HEARN, ASHLEY N (LGSW)
Entity type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:N
Last Name:HEARN
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:M/S: PP/102/CC
Mailing Address - Street 2:VA MEDICAL HEALTH CENTER
Mailing Address - City:PERRY POINT
Mailing Address - State:MD
Mailing Address - Zip Code:21092
Mailing Address - Country:US
Mailing Address - Phone:410-642-2411
Mailing Address - Fax:
Practice Address - Street 1:M/S: PP/102/CC
Practice Address - Street 2:VA MEDICAL HEALTH CENTER
Practice Address - City:PERRY POINT
Practice Address - State:MD
Practice Address - Zip Code:21092
Practice Address - Country:US
Practice Address - Phone:410-642-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21085104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker