Provider Demographics
NPI:1679756647
Name:HARTLAGE, STEVEN E (LSW)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:E
Last Name:HARTLAGE
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:MR
Other - First Name:STEVEN
Other - Middle Name:E
Other - Last Name:HARTLAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:901 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-3944
Mailing Address - Country:US
Mailing Address - Phone:740-354-7702
Mailing Address - Fax:740-353-1662
Practice Address - Street 1:901 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-3944
Practice Address - Country:US
Practice Address - Phone:740-355-8606
Practice Address - Fax:740-353-1662
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
OHS-0020899101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health