Provider Demographics
NPI:1376438788
Name:HART, KATHERINE NICOLE
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:NICOLE
Last Name:HART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2264 FINK AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-1216
Mailing Address - Country:US
Mailing Address - Phone:570-772-3282
Mailing Address - Fax:
Practice Address - Street 1:1341 E 3RD ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-5409
Practice Address - Country:US
Practice Address - Phone:570-601-4325
Practice Address - Fax:570-866-3141
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health