Provider Demographics
NPI:1003269929
Name:HARTMAN, LISA F (LCSW, CADC)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:F
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 SILVER ROCK LN
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1436
Mailing Address - Country:US
Mailing Address - Phone:847-525-8686
Mailing Address - Fax:
Practice Address - Street 1:871 SILVER ROCK LN
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1436
Practice Address - Country:US
Practice Address - Phone:847-525-8686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL16571101YA0400X
IL149.0178951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)