Provider Demographics
NPI:1285905208
Name:HAGY, JESSICA MEGARY (LCSW-C)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MEGARY
Last Name:HAGY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ERIN
Other - Last Name:MEGARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LGSW
Mailing Address - Street 1:314 FRANKLIN AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811
Mailing Address - Country:US
Mailing Address - Phone:410-973-2525
Mailing Address - Fax:410-973-2527
Practice Address - Street 1:314 FRANKLIN AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811
Practice Address - Country:US
Practice Address - Phone:410-973-2525
Practice Address - Fax:410-973-2527
Is Sole Proprietor?:No
Enumeration Date:2012-01-23
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17253104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD346646OtherMHN
MD259147-000OtherMAGELLAN
MD517251OtherOPTUM
MD609550001Medicaid
MD7840093OtherAETNA
MD609550004Medicaid
MDR968OtherCAREFIRST BCBS FEDERAL
MD522156095OtherCOMMERCIAL
MDLM49EAOtherCAREFIRST BCBS LOCAL
MDR968OtherCAREFIRST BCBS FEDERAL