MEDICARE: ABBY HEARST LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	6343G	AL

General Provider Information

NPI Number	:	1891570206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBY HEARST LMSW

Provider Business Mailing Address
First Line	:	6640 ROCK LEDGE RD
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-7683
Country	:	US
Telephone Number	:	478-957-7967
Fax Number	:

Provider Business Practice Location Address
First Line	:	3820 HARRISON RD
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36109-4508
Country	:	US
Telephone Number	:	334-322-4437
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2023
Last Update Date	:	08/25/2023

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