Provider Demographics
NPI:1487241634
Name:HARTSOCK, RHONI
Entity type:Individual
Prefix:
First Name:RHONI
Middle Name:
Last Name:HARTSOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 S 19TH ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-7010
Mailing Address - Country:US
Mailing Address - Phone:563-212-2042
Mailing Address - Fax:
Practice Address - Street 1:2727 S 19TH ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-7010
Practice Address - Country:US
Practice Address - Phone:563-212-2042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA101YA0400XMedicaid