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NPI Code Detail

MEDICARE: ELVA HART LCSW

MEDICARE:   ELVA  HART  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker56813TX

General Provider Information

NPI Number : 1790247864
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELVA HART LCSW
Provider Business Mailing Address
First Line : 3526 PRESCOTT AVE
Second Line :
City : DALLAS
State : TX
Zip : 75219-2147
Country : US
Telephone Number : 469-563-5161
Fax Number :
Provider Business Practice Location Address
First Line : 3526 PRESCOTT AVE
Second Line :
City : DALLAS
State : TX
Zip : 75219-2147
Country : US
Telephone Number : 469-563-5161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2019
Last Update Date : 04/05/2019

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Directions to “ ELVA HART LCSW” Practice Location

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