Provider Demographics
NPI:1457576134
Name:HART, VERONICA MARIE I (MS, NCAC II, CDP)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:MARIE
Last Name:HART
Suffix:I
Gender:F
Credentials:MS, NCAC II, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 E 4TH AVE
Mailing Address - Street 2:SUITE #205
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-3189
Mailing Address - Country:US
Mailing Address - Phone:509-962-6626
Mailing Address - Fax:
Practice Address - Street 1:103 E 4TH AVE
Practice Address - Street 2:SUITE #205
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3189
Practice Address - Country:US
Practice Address - Phone:509-962-6626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00001720101YA0400X
WARC00012472101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health