Provider Demographics
NPI:1285077164
Name:HEARN, ANDREW J (LMSW)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:J
Last Name:HEARN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 UNION SQ W
Mailing Address - Street 2:SUITE 509
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3303
Mailing Address - Country:US
Mailing Address - Phone:917-971-2672
Mailing Address - Fax:
Practice Address - Street 1:218 W 10TH ST
Practice Address - Street 2:#5E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-2975
Practice Address - Country:US
Practice Address - Phone:917-971-2672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043928-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY043928-1OtherNEW YORK STATE SOCIAL WORK LICENSE NUMBER