Provider Demographics
NPI:1902208820
Name:HART, DANIELLE (BA)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6179
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-6179
Mailing Address - Country:US
Mailing Address - Phone:740-775-1260
Mailing Address - Fax:740-773-1264
Practice Address - Street 1:1011 MISSION DR
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-5561
Practice Address - Country:US
Practice Address - Phone:304-485-1781
Practice Address - Fax:304-485-1781
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
OHS.2411642104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor