Provider Demographics
NPI:1336219369
Name:HITCHENS, GARY (LCPC)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:HITCHENS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 TWINBROOK PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20851-1400
Mailing Address - Country:US
Mailing Address - Phone:240-777-1692
Mailing Address - Fax:
Practice Address - Street 1:751 TWINBROOK PKWY
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20851-1400
Practice Address - Country:US
Practice Address - Phone:240-777-1692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0447101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional