Provider Demographics
NPI:1518069277
Name:HART, LORRAINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6638 W OTTAWA AVE
Mailing Address - Street 2:SUITE 170-5
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-4562
Mailing Address - Country:US
Mailing Address - Phone:303-985-4585
Mailing Address - Fax:
Practice Address - Street 1:6638 W OTTAWA AVE
Practice Address - Street 2:SUITE 170-5
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-4562
Practice Address - Country:US
Practice Address - Phone:303-985-4585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO910103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC60566Medicare PIN