Provider Demographics
NPI:1992814172
Name:HARE, JAMES SIDNEY (LCSW)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:SIDNEY
Last Name:HARE
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 1:800 FLEMING ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3528
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:828-693-9560
Practice Address - Street 1:493 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:NC
Practice Address - Zip Code:28753-3901
Practice Address - Country:US
Practice Address - Phone:828-649-2367
Practice Address - Fax:828-649-3859
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0005181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC135V3OtherNVML BCBSNC GRP # 015HF
NC6003048Medicaid
NC6003048Medicaid