Individual
MR. GRANT R HASTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3135 SUMMIT BRIDGE RD, BEAR, DE 19701-2001
(302) 464-0515
(302) 454-7274
Mailing address
34 DALTON DR, NEWARK, DE 19702-2059
(302) 275-8577
(302) 454-7274
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
Q10000765
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000035733
—
DC
05
—
1000039721
—
DE
01
—
166706 YDXJ
MEDICARE PTAN
DE
Enumeration date
10/09/2007
Last updated
02/23/2016
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