Provider Demographics
NPI:1295329563
Name:DEHART, JAMES BRADLEY (MSW)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:BRADLEY
Last Name:DEHART
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 SE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-1104
Mailing Address - Country:US
Mailing Address - Phone:270-929-1762
Mailing Address - Fax:833-812-0155
Practice Address - Street 1:1727 SWEENEY ST STE 104
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-3834
Practice Address - Country:US
Practice Address - Phone:270-929-1762
Practice Address - Fax:833-812-0155
Is Sole Proprietor?:No
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker