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General NPI Number Information
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NPI Number | 1619665213
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Entity Type | Individual
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Provider Name | JOANNE HARTLE
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Gender | Female
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Dates
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Enumeration Date | 05/01/2023
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 10427 NORTH ST STE 201
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City | FAIRFAX
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State | VA
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Zip | 22030-2592
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Country | US
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Telephone | 571-383-2540
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Fax |
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Provider Business Mailing Address
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Address Line | 3921 BLENHEIM BLVD
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City | FAIRFAX
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State | VA
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Zip | 22030-2429
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Country | US
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Telephone | 571-268-2226
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904017230
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | PPS0608050
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License Number State | VA
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