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General NPI Number Information
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NPI Number | 1578702072
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Entity Type | Organization
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Legal Business Name | HART BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 02/07/2009
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Last Update Date | 02/07/2009
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Provider Practice Location Address
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Address Line | 503 RIDGEWOOD DR
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City | FLORENCE
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State | SC
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Zip | 29501-5519
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Country | US
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Telephone | 843-679-9200
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Fax | 843-665-8676
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Provider Business Mailing Address
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Address Line | 503 RIDGEWOOD DR
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City | FLORENCE
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State | SC
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Zip | 29501-5519
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Country | US
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Telephone | 843-679-9200
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Fax | 843-665-8676
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Authorized Official
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Title or Position | PRESIDENT
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Name | JANE HART LEWIS
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Credential | MS, LPC, LPCS, NCC
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Telephone | 843-679-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC 1922
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License Number State | SC
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