Provider Demographics
NPI:1386019602
Name:HASSAAN, ABDULLAH (MS)
Entity type:Individual
Prefix:
First Name:ABDULLAH
Middle Name:
Last Name:HASSAAN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:CHAUNCY
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3304 TIMBER TRL
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-1011
Mailing Address - Country:US
Mailing Address - Phone:615-596-9477
Mailing Address - Fax:
Practice Address - Street 1:3304 TIMBER TRL
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-1011
Practice Address - Country:US
Practice Address - Phone:615-596-9477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health