Provider Demographics
NPI:1174916688
Name:HARTE BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:HARTE BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:B
Authorized Official - Last Name:HARTE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:512-567-3821
Mailing Address - Street 1:95 WASHINGTON ST STE 588
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-4003
Mailing Address - Country:US
Mailing Address - Phone:781-713-4001
Mailing Address - Fax:781-713-4038
Practice Address - Street 1:95 WASHINGTON ST STE 588
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-4003
Practice Address - Country:US
Practice Address - Phone:781-713-4001
Practice Address - Fax:781-713-4038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-07
Last Update Date:2015-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9809103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS400192644OtherMEDICARE PTAN