1467999227 NPI number — LISA JEAN HARTNETT LICSW

Table of content: LISA JEAN HARTNETT LICSW (NPI 1467999227)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467999227 NPI number — LISA JEAN HARTNETT LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARTNETT
Provider First Name:
LISA
Provider Middle Name:
JEAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LICSW
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:
1467999227
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/31/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23 GRANT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03867-3001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-332-7701
Provider Business Mailing Address Fax Number:
603-332-9629

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23 GRANT ST
Provider Second Line Business Practice Location Address:
NH CATHOLIC CHARITIES
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03867-3001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-332-7701
Provider Business Practice Location Address Fax Number:
603-332-9629
Provider Enumeration Date:
01/31/2017

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:  1407 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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