Provider Demographics
NPI:1063099174
Name:HANNAH, HAILEE NICOLE (LMHCA)
Entity type:Individual
Prefix:
First Name:HAILEE
Middle Name:NICOLE
Last Name:HANNAH
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7707 86TH DR NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-7415
Mailing Address - Country:US
Mailing Address - Phone:425-535-0937
Mailing Address - Fax:
Practice Address - Street 1:11711 SE 8TH ST STE 315
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3543
Practice Address - Country:US
Practice Address - Phone:425-535-0937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61066476101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA