Provider Demographics
NPI:1609540418
Name:HITCH, KATHLEEN N (LCSW-C)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:N
Last Name:HITCH
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 1:255 GARRISON WAY
Mailing Address - Street 2:
Mailing Address - City:FRUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21826-2123
Mailing Address - Country:US
Mailing Address - Phone:443-880-3627
Mailing Address - Fax:
Practice Address - Street 1:255 GARRISON WAY
Practice Address - Street 2:
Practice Address - City:FRUITLAND
Practice Address - State:MD
Practice Address - Zip Code:21826-2123
Practice Address - Country:US
Practice Address - Phone:443-880-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD238731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical