Basic Information
| Provider Information | |||||||||
| NPI: | 1679574446 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCGANN | ||||||||
| FirstName: | ELAINE | ||||||||
| MiddleName: | HARTMAN | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6356 RAWLEY PIKE | ||||||||
| Address2: | |||||||||
| City: | HINTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228312001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5408675854 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1241 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228024632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404341941 | ||||||||
| FaxNumber: | 5404338277 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2005 | ||||||||
| LastUpdateDate: | 02/07/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 0810002855 | VA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 084301M | 01 | VA | SENTARA | OTHER | 453345 | 01 | VA | ANTHEM | OTHER |