Provider Demographics
NPI:1285314518
Name:HARTZ, KARLY (LPC)
Entity type:Individual
Prefix:
First Name:KARLY
Middle Name:
Last Name:HARTZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 LEWIS BURWELL PL
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-4706
Mailing Address - Country:US
Mailing Address - Phone:716-425-8713
Mailing Address - Fax:
Practice Address - Street 1:210 LEWIS BURWELL PL
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-4706
Practice Address - Country:US
Practice Address - Phone:716-425-8713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC014042101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional