Provider Demographics
NPI:1588639249
Name:HARTMANN, KATHRIN (PHD)
Entity Type:Individual
Prefix:PROF
First Name:KATHRIN
Middle Name:
Last Name:HARTMANN
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 1:309 LYNNHAVEN PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7411
Mailing Address - Country:US
Mailing Address - Phone:757-839-5888
Mailing Address - Fax:757-446-5918
Practice Address - Street 1:309 LYNNHAVEN PARKWAY
Practice Address - Street 2:SUITE 1
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7411
Practice Address - Country:US
Practice Address - Phone:757-839-5888
Practice Address - Fax:757-446-5918
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002141103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA-006OtherTRICARE/CHAMPUS
VAPAROtherCORVEL/CORCARE
VAPAROtherFIRST HEALTH COMMERCIAL
VA325309OtherANTHEM
VA007710259Medicaid
VA343836OtherMANAGED HEALTH NETWORK
VAPAROtherAETNA
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherMULTIPLAN
VAPAROtherUSA MANAGED CARE
VAPAROtherVIRGINIA HEALTH NETWORK
VAO-86184OtherSENTARA OPTIMA
VAPAROtherUNITED BEHAVIORAL HEALTH
VAPAROtherCIGNA BEHAVIORAL HEALTH
VA150247OtherMAGELLAN HEALTH SERVICES
VAPAROtherVALUE OPTIONS
VA-006OtherTRICARE/CHAMPUS
VA343836OtherMANAGED HEALTH NETWORK
VAPAROtherVIRGINIA HEALTH NETWORK