Provider Demographics
NPI:1053017533
Name:HARDCASTLE, BRIANNA M (LCSW-C)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:M
Last Name:HARDCASTLE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 ROUND UP RD
Mailing Address - Street 2:
Mailing Address - City:LUSBY
Mailing Address - State:MD
Mailing Address - Zip Code:20657-3456
Mailing Address - Country:US
Mailing Address - Phone:360-672-0538
Mailing Address - Fax:
Practice Address - Street 1:23620 THREE NOTCH RD UNIT 101
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:MD
Practice Address - Zip Code:20636-3083
Practice Address - Country:US
Practice Address - Phone:240-324-8992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD257071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical