Provider Demographics
NPI:1366973026
Name:HANNON, DANIEL (PHD, LCMHC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:HANNON
Suffix:
Gender:M
Credentials:PHD, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 BRADY AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2803
Mailing Address - Country:US
Mailing Address - Phone:603-475-6141
Mailing Address - Fax:
Practice Address - Street 1:135 BRADY AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2803
Practice Address - Country:US
Practice Address - Phone:603-475-6141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-24
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1185101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health