1538527585 NPI number — ROSEMARY AHEARN-HASARA LCSW, CLINICAL SOCIA

Table of content: ROSEMARY AHEARN-HASARA LCSW, CLINICAL SOCIA (NPI 1538527585)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538527585 NPI number — ROSEMARY AHEARN-HASARA LCSW, CLINICAL SOCIA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AHEARN-HASARA
Provider First Name:
ROSEMARY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW, CLINICAL SOCIA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538527585
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/26/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
351 STONEHENGE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILLIPSBURG
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08865-2075
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-213-2214
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
467 CREAMERY WAY
Provider Second Line Business Practice Location Address:
HOLCOMB BEHAVIORAL HEALTH SYSTEMS
Provider Business Practice Location Address City Name:
EXTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19341
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-330-9862
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/05/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  CW018443 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: 44SC04590500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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