Provider Demographics
NPI:1912056763
Name:HESLEY, JAN GAIL (LCSW)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:GAIL
Last Name:HESLEY
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 1:6031 INTERSTATE 20 W
Mailing Address - Street 2:SUITE 253
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-1084
Mailing Address - Country:US
Mailing Address - Phone:817-478-0666
Mailing Address - Fax:817-478-1183
Practice Address - Street 1:6031 INTERSTATE 20 W
Practice Address - Street 2:SUITE 253
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1084
Practice Address - Country:US
Practice Address - Phone:817-478-0666
Practice Address - Fax:817-478-1183
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical