Provider Demographics
NPI:1992774319
Name:HARTZ, JOHN CALVIN (LCSW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CALVIN
Last Name:HARTZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SCHWEINFURT ARMY HEALTH CLINIC
Mailing Address - Street 2:CMR 457, UNIT 25850, BOX 718
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09033-0000
Mailing Address - Country:US
Mailing Address - Phone:0114-997-2196
Mailing Address - Fax:01149972-196-6872
Practice Address - Street 1:SCHWEINFURT ARMY HEALTH CLINIC
Practice Address - Street 2:CMR 457, UNIT 25850, BOX 718
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09033
Practice Address - Country:US
Practice Address - Phone:0114-997-2196
Practice Address - Fax:01149972-196-6872
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX291421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical