Healthcare Provider Details

I. General information

NPI: 1083549638
Provider Name (Legal Business Name): HEARTROVERTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 HAWLINGS RIVER RD
LAUREL MD
20708-3408
US

IV. Provider business mailing address

123 HAWLINGS RIVER RD
LAUREL MD
20708-3408
US

V. Phone/Fax

Practice location:
  • Phone: 443-333-9550
  • Fax:
Mailing address:
  • Phone: 443-333-9550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. ASHLEY M BARNES
Title or Position: MANAGING MEMBER
Credential: LCPC
Phone: 443-333-9550