Provider Demographics
NPI:1679786537
Name:HARTIN, ARTHUR JOSEPH (MSW LICSW)
Entity type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:JOSEPH
Last Name:HARTIN
Suffix:
Gender:M
Credentials:MSW LICSW
Other - Prefix:MR
Other - First Name:ARTHUR
Other - Middle Name:JOSEPH
Other - Last Name:HARTIN
Other - Suffix:JR
Other - Last Name Type:Former Name
Other - Credentials:MSW LICSW
Mailing Address - Street 1:275 BROOKLYN STREET
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661
Mailing Address - Country:US
Mailing Address - Phone:802-888-5026
Mailing Address - Fax:802-888-6393
Practice Address - Street 1:520 WASHINGTON HIGHWAY
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661
Practice Address - Country:US
Practice Address - Phone:802-888-4914
Practice Address - Fax:802-888-5916
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0890000032104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0006039Medicaid
VT1007502Medicaid
VT1009781Medicaid