Provider Demographics
NPI:1962722967
Name:HARTMAN, KATHARINA E (LCPC)
Entity type:Individual
Prefix:
First Name:KATHARINA
Middle Name:E
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 SMUTTY LN
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-9719
Mailing Address - Country:US
Mailing Address - Phone:207-699-4301
Mailing Address - Fax:
Practice Address - Street 1:86 SMUTTY LN
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-9719
Practice Address - Country:US
Practice Address - Phone:207-229-6227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC4322101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME435707199Medicaid