Provider Demographics
NPI:1396881785
Name:HARTMAN, ALISON ADAMS (LMSW, ACSW)
Entity type:Individual
Prefix:MS
First Name:ALISON
Middle Name:ADAMS
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:LMSW, ACSW
Other - Prefix:MS
Other - First Name:KATHLEEN
Other - Middle Name:ALISON
Other - Last Name:HARTMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW, ACSW
Mailing Address - Street 1:PO BOX 1646
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48641-1646
Mailing Address - Country:US
Mailing Address - Phone:989-274-9890
Mailing Address - Fax:989-892-4761
Practice Address - Street 1:1217 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-3311
Practice Address - Country:US
Practice Address - Phone:989-667-9661
Practice Address - Fax:989-667-9680
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010789471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN39910007Medicare ID - Type Unspecified
MIOP22930Medicare ID - Type Unspecified