Provider Demographics
NPI:1912353566
Name:HARTWELL, GLORIA (LGPC)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:HARTWELL
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 DOGWOOD RD STE 201
Mailing Address - Street 2:
Mailing Address - City:WOODLAWN
Mailing Address - State:MD
Mailing Address - Zip Code:21207-5295
Mailing Address - Country:US
Mailing Address - Phone:410-653-0021
Mailing Address - Fax:410-653-0070
Practice Address - Street 1:6401 DOGWOOD RD STE 201
Practice Address - Street 2:
Practice Address - City:WOODLAWN
Practice Address - State:MD
Practice Address - Zip Code:21207-5295
Practice Address - Country:US
Practice Address - Phone:410-653-0021
Practice Address - Fax:410-653-0070
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP6614101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health