Provider Demographics
NPI:1548535073
Name:HACKEY, DANA M (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:M
Last Name:HACKEY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26826 KAYE RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:DE
Mailing Address - Zip Code:19956-2608
Mailing Address - Country:US
Mailing Address - Phone:240-422-3556
Mailing Address - Fax:302-990-5985
Practice Address - Street 1:22 E SECOND ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5303
Practice Address - Country:US
Practice Address - Phone:240-422-3556
Practice Address - Fax:301-698-9369
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-16
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC1561101YA0400X
MD144351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)