Provider Demographics
NPI:1760958003
Name:HARTMAN, ALICIA LANE (LCMHC)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:LANE
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5436 LAKE EDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-9341
Mailing Address - Country:US
Mailing Address - Phone:919-895-0039
Mailing Address - Fax:
Practice Address - Street 1:4928 LINKSLAND DR STE 204
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-7455
Practice Address - Country:US
Practice Address - Phone:919-895-0039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-14
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13686101YM0800X
NC13686101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health