Provider Demographics
NPI:1679024814
Name:HART, ANNA COLLEEN (CRC)
Entity Type:Individual
Prefix:MS
First Name:ANNA
Middle Name:COLLEEN
Last Name:HART
Suffix:
Gender:F
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 FINLEY FOREST DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-8689
Mailing Address - Country:US
Mailing Address - Phone:910-612-2718
Mailing Address - Fax:
Practice Address - Street 1:263 PENNY LN
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-4918
Practice Address - Country:US
Practice Address - Phone:919-869-3419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00212207101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health