Provider Demographics
NPI:1013903194
Name:HARTT, KAREN A (LCSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:HARTT
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:PO BOX 1312
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-0312
Mailing Address - Country:US
Mailing Address - Phone:570-283-0777
Mailing Address - Fax:570-283-1570
Practice Address - Street 1:265 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-3501
Practice Address - Country:US
Practice Address - Phone:570-283-0777
Practice Address - Fax:570-283-0777
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW006833L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA809919OtherFIRST PRIORITY HEALTH