Provider Demographics
NPI:1427502574
Name:ALLYN, HANK (MSW LISAC)
Entity type:Individual
Prefix:
First Name:HANK
Middle Name:
Last Name:ALLYN
Suffix:
Gender:M
Credentials:MSW LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 N CHERI LYNN DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-6936
Mailing Address - Country:US
Mailing Address - Phone:480-332-7454
Mailing Address - Fax:
Practice Address - Street 1:461 N CHERI LYNN DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-6936
Practice Address - Country:US
Practice Address - Phone:480-332-7454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-06
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-1510101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)