Provider Demographics
NPI:1982843132
Name:HARTMAN, MELISSA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 2ND ST E
Mailing Address - Street 2:SUITE #210
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2410
Mailing Address - Country:US
Mailing Address - Phone:406-260-6706
Mailing Address - Fax:406-863-4809
Practice Address - Street 1:100 2ND ST E
Practice Address - Street 2:SUITE #210
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2410
Practice Address - Country:US
Practice Address - Phone:406-260-6706
Practice Address - Fax:406-863-4809
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical