Provider Demographics
NPI:1093483299
Name:HARTNETT, KERRI (MSS, LSW)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:HARTNETT
Suffix:
Gender:F
Credentials:MSS, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 E MECHANIC ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-1118
Mailing Address - Country:US
Mailing Address - Phone:717-515-2279
Mailing Address - Fax:
Practice Address - Street 1:1500 CHESTNUT ST # 1927
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-2737
Practice Address - Country:US
Practice Address - Phone:302-252-5277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA136891104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty