Healthcare Provider Details

I. General information

NPI: 1598897563
Provider Name (Legal Business Name): HARTMAN COUNSELING & PSYCHOLOGICAL SERVICES P.S. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 01/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11808 NORTHUP WAY STE W150
BELLEVUE WA
98005-1936
US

IV. Provider business mailing address

11808 NORTHUP WAY STE W150
BELLEVUE WA
98005-1936
US

V. Phone/Fax

Practice location:
  • Phone: 425-889-1240
  • Fax: 425-889-1249
Mailing address:
  • Phone: 425-889-1240
  • Fax: 425-889-1249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY2597
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW4694
License Number StateWA

VIII. Authorized Official

Name: RENEE R HARTMAN
Title or Position: CHILD AND ADOLESCENT PSYCHOLOGIST
Credential: PHD
Phone: 425-889-1240