Provider Demographics
NPI:1962190140
Name:HARTNETT, JOAN M
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:HARTNETT
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 1:90 RED OAK LN
Mailing Address - Street 2:
Mailing Address - City:WEST BARNSTABLE
Mailing Address - State:MA
Mailing Address - Zip Code:02668-1760
Mailing Address - Country:US
Mailing Address - Phone:508-280-7612
Mailing Address - Fax:
Practice Address - Street 1:90 RED OAK LN
Practice Address - Street 2:
Practice Address - City:WEST BARNSTABLE
Practice Address - State:MA
Practice Address - Zip Code:02668-1760
Practice Address - Country:US
Practice Address - Phone:508-280-7612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA846101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health