Provider Demographics
NPI:1679574446
Name:MCGANN, ELAINE HARTMAN (PHD)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:HARTMAN
Last Name:MCGANN
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 1:6356 RAWLEY PIKE
Mailing Address - Street 2:
Mailing Address - City:HINTON
Mailing Address - State:VA
Mailing Address - Zip Code:22831-2001
Mailing Address - Country:US
Mailing Address - Phone:540-867-5854
Mailing Address - Fax:
Practice Address - Street 1:1241 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802-4632
Practice Address - Country:US
Practice Address - Phone:540-434-1941
Practice Address - Fax:540-433-8277
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002855103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA084301MOtherSENTARA
VA453345OtherANTHEM
P40825Medicare UPIN
VAC00836Medicare PIN