Basic Information
Provider Information
NPI: 1629484845
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HART
FirstName: JOY
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1111 N CHARLES ST
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212015505
CountryCode: US
TelephoneNumber: 4108372050
FaxNumber: 8666290091
Practice Location
Address1: 5500 KNOLL NORTH DR STE 370
Address2:  
City: COLUMBIA
State: MD
PostalCode: 210452393
CountryCode: US
TelephoneNumber: 4108372050
FaxNumber: 8666290091
Other Information
ProviderEnumerationDate: 07/08/2014
LastUpdateDate: 05/08/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/08/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X20142MDY Behavioral Health & Social Service ProvidersSocial WorkerClinical

ID Information
IDTypeStateIssuerDescription
2014201MDMARYLAND BOARD OF SOCIAL WORK EXAMINERSOTHER


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