Provider Demographics
NPI:1396563474
Name:HART, KATHRYN (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2491 S HANSEN BLVD
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-1885
Mailing Address - Country:US
Mailing Address - Phone:312-619-8479
Mailing Address - Fax:
Practice Address - Street 1:2491 S HANSEN BLVD
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-1885
Practice Address - Country:US
Practice Address - Phone:312-619-8479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-28
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34011043A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical