Provider Demographics
NPI:1609299155
Name:HARTSHORN, DEANA ANN (MA, LPC)
Entity type:Individual
Prefix:
First Name:DEANA
Middle Name:ANN
Last Name:HARTSHORN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1482 BRIMBLE DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-7254
Mailing Address - Country:US
Mailing Address - Phone:303-775-3249
Mailing Address - Fax:
Practice Address - Street 1:1317 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:FLAGLER BEACH
Practice Address - State:FL
Practice Address - Zip Code:32136-3144
Practice Address - Country:US
Practice Address - Phone:386-585-5590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0016071101YM0800X
TX94948101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health