Provider Demographics
NPI:1083797724
Name:HART, MISHELE LEE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MISHELE
Middle Name:LEE
Last Name:HART
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:MISHELE
Other - Middle Name:LEE
Other - Last Name:HART LAMBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:7855 ARGYLE FOREST BLVD. #907
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-7707
Mailing Address - Country:US
Mailing Address - Phone:904-287-9195
Mailing Address - Fax:904-317-9520
Practice Address - Street 1:7855 ARGYLE FOREST BLVD. #907
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-7707
Practice Address - Country:US
Practice Address - Phone:904-287-9195
Practice Address - Fax:904-317-9520
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW57921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical