Provider Demographics
NPI:1215295076
Name:REILLY, HANNAH R (MS, LIMHP)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:R
Last Name:REILLY
Suffix:
Gender:F
Credentials:MS, LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 N 115TH ST STE 205
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4422
Mailing Address - Country:US
Mailing Address - Phone:402-915-2585
Mailing Address - Fax:
Practice Address - Street 1:1045 N 115TH ST STE 205
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-4422
Practice Address - Country:US
Practice Address - Phone:402-915-2585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1301101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty