Provider Demographics
NPI:1619167467
Name:HART, JANICE DENE (MSW , LCSW)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:DENE
Last Name:HART
Suffix:
Gender:F
Credentials:MSW , LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 WHITE LAKES AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-1659
Mailing Address - Country:US
Mailing Address - Phone:702-982-5459
Mailing Address - Fax:702-982-5459
Practice Address - Street 1:482 MAIN ST NW
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-2331
Practice Address - Country:US
Practice Address - Phone:815-936-3370
Practice Address - Fax:815-939-1501
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0106301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical