Provider Demographics
NPI:1184443079
Name:HARTMAN, SARA CATHERINE (ALC, CRC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:CATHERINE
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:ALC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 LOYOLA DR
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-1328
Mailing Address - Country:US
Mailing Address - Phone:334-805-0186
Mailing Address - Fax:334-805-0186
Practice Address - Street 1:500 CHASE PARK S STE 130
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-1869
Practice Address - Country:US
Practice Address - Phone:205-259-8211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-08
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC05041101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health