Provider Demographics
NPI:1649600776
Name:HARTSHORNE, KANJANA MICHELLE (MSW, LCSW, C-IAYT)
Entity Type:Individual
Prefix:
First Name:KANJANA
Middle Name:MICHELLE
Last Name:HARTSHORNE
Suffix:
Gender:F
Credentials:MSW, LCSW, C-IAYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:ROMANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-4822
Mailing Address - Country:US
Mailing Address - Phone:610-790-3442
Mailing Address - Fax:
Practice Address - Street 1:860 E SWEDESFORD RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-2130
Practice Address - Country:US
Practice Address - Phone:610-790-3442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0183961041C0700X
PASW129522104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical