Provider Demographics
NPI:1285167957
Name:HART, CARA (MA, LPC, MT-BC)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:MA, LPC, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 N WAVERLY ST
Mailing Address - Street 2:
Mailing Address - City:SHILLINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19607-1206
Mailing Address - Country:US
Mailing Address - Phone:610-223-0107
Mailing Address - Fax:
Practice Address - Street 1:99 S WAVERLY ST
Practice Address - Street 2:
Practice Address - City:SHILLINGTON
Practice Address - State:PA
Practice Address - Zip Code:19607-2641
Practice Address - Country:US
Practice Address - Phone:484-240-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-09
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA13778225A00000X
374J00000X
PAPC015924101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
No374J00000XNursing Service Related ProvidersDoula