Provider Demographics
NPI:1407247174
Name:HARTZELL, ANDREW CHARLES
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:CHARLES
Last Name:HARTZELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 W 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-5102
Mailing Address - Country:US
Mailing Address - Phone:303-412-3901
Mailing Address - Fax:
Practice Address - Street 1:77 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-5102
Practice Address - Country:US
Practice Address - Phone:303-412-3901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health