Provider Demographics
NPI:1811523491
Name:KATELIN HANHART LICENSED CLINICAL SOCIAL WORKER PC
Entity type:Organization
Organization Name:KATELIN HANHART LICENSED CLINICAL SOCIAL WORKER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATELIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HANHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-994-4600
Mailing Address - Street 1:32169 CORTE SABRINAS
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-1243
Mailing Address - Country:US
Mailing Address - Phone:732-688-7130
Mailing Address - Fax:
Practice Address - Street 1:3784 MISSION AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-1460
Practice Address - Country:US
Practice Address - Phone:760-994-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty