Healthcare Provider Details

I. General information

NPI: 1659842748
Provider Name (Legal Business Name): ERIC HARTMAN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 12/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 DUBLIN RD
COLUMBUS OH
43215-1025
US

IV. Provider business mailing address

5385 SHOTGUN DR
CANAL WINCHESTER OH
43110-9027
US

V. Phone/Fax

Practice location:
  • Phone: 614-488-7117
  • Fax: 614-488-7118
Mailing address:
  • Phone: 740-503-2898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.1200595
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: