Provider Demographics
NPI:1578062154
Name:HARTMANN, JANE CONNELL (LCSW)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:CONNELL
Last Name:HARTMANN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:GRACE
Other - Last Name:CONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4180 ASPEN LN
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-8422
Mailing Address - Country:US
Mailing Address - Phone:847-691-8244
Mailing Address - Fax:
Practice Address - Street 1:4180 ASPEN LN
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-8422
Practice Address - Country:US
Practice Address - Phone:847-691-8244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-08
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099252511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical