Provider Demographics
NPI:1578979522
Name:HARTU, ANA SAGE (LCPC, CADC, NCC)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:SAGE
Last Name:HARTU
Suffix:
Gender:F
Credentials:LCPC, CADC, NCC
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:SAGE
Other - Last Name:HAMERSMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, CADC
Mailing Address - Street 1:7641 KODIAK AVE NE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-4402
Mailing Address - Country:US
Mailing Address - Phone:708-334-5949
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-2321
Practice Address - Country:US
Practice Address - Phone:253-966-3266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IL180013201101YP2500X
IL32882101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)