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PAUL MICHAEL HART LCSW

Clinical >> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1053498816

Individual Registrant:
 PAUL MICHAEL HART LCSW
Gender: M
Sole Proprietor

Location and contact information for practice:
10560 MAIN ST SUITE 410 FAIRFAX, VA 22030-7182 US
Tel: 703-352-9851  Fax: 703-352-9040

Contact information for business:
2311 PIMMIT DR APT 318  FALLS CHURCH, VA 22043-2815 US
Tel: 703-568-9507  Fax: --

Registration Information:
NPI: 1053498816
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
Clinical
VA0904004480

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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