1386748820 NPI number — KATHLEEN ANNE HARTMAN-MCCARTHY LCSW

Table of content: KATHLEEN ANNE HARTMAN-MCCARTHY LCSW (NPI 1386748820)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386748820 NPI number — KATHLEEN ANNE HARTMAN-MCCARTHY LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARTMAN-MCCARTHY
Provider First Name:
KATHLEEN
Provider Middle Name:
ANNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386748820
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/19/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1616 E CLINTON TRL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48813-9334
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-242-4862
Provider Business Mailing Address Fax Number:
219-529-6297

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1616 E CLINTON TRL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48813-9334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
219-242-4862
Provider Business Practice Location Address Fax Number:
219-529-6297
Provider Enumeration Date:
09/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  34004490A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: 6801114278 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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