Provider Demographics
NPI:1821774290
Name:HART, JAMES GEHRET (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:GEHRET
Last Name:HART
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 W MAIN ST UNIT 1317
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-9159
Mailing Address - Country:US
Mailing Address - Phone:540-330-4278
Mailing Address - Fax:
Practice Address - Street 1:1014 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-4420
Practice Address - Country:US
Practice Address - Phone:540-330-4278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040143171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical