Individual
GINA HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LADC1
Contact information
Practice address
29 PENNYBROOK RD, LYNN, MA 01905
(617) 653-4087
Mailing address
29 PENNYBROOK RD, LYNN, MA 01905-1010
(617) 653-4087
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15280
MA
101YM0800X
Mental Health Counselor
221793
MA
Other
Enumeration date
04/24/2017
Last updated
04/24/2017
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