Healthcare Provider Details

I. General information

NPI: 1114453149
Provider Name (Legal Business Name): BRITNI LEIGH HARDESTY LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 PUBLIC LANDING RD
SNOW HILL MD
21863-2453
US

IV. Provider business mailing address

6040 PUBLIC LANDING RD
SNOW HILL MD
21863-2453
US

V. Phone/Fax

Practice location:
  • Phone: 410-632-1100
  • Fax: 410-632-0906
Mailing address:
  • Phone: 410-632-1100
  • Fax: 410-632-5682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number24765
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: