Provider Demographics
NPI:1104433275
Name:HART, CHEYANNE (LCSW, LMSW)
Entity type:Individual
Prefix:
First Name:CHEYANNE
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:LCSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 PAGE DR S STE 101
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-3551
Mailing Address - Country:US
Mailing Address - Phone:701-300-8879
Mailing Address - Fax:
Practice Address - Street 1:1330 PAGE DR S STE 101
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-3551
Practice Address - Country:US
Practice Address - Phone:701-300-8879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND59941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical