Provider Demographics
NPI:1457990350
Name:HARTFORD, DANNIELLE (CADC)
Entity Type:Individual
Prefix:
First Name:DANNIELLE
Middle Name:
Last Name:HARTFORD
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-8302
Mailing Address - Country:US
Mailing Address - Phone:844-294-5306
Mailing Address - Fax:844-294-5306
Practice Address - Street 1:841 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-8302
Practice Address - Country:US
Practice Address - Phone:844-294-5306
Practice Address - Fax:844-294-5306
Is Sole Proprietor?:No
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC7078101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)