Provider Demographics
NPI:1528442449
Name:HANN, CHERYL (BS)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:HANN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:777 COLUMBUS AVE STE 7-D
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-1684
Mailing Address - Country:US
Mailing Address - Phone:513-228-6590
Mailing Address - Fax:
Practice Address - Street 1:7 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3921
Practice Address - Country:US
Practice Address - Phone:603-889-6147
Practice Address - Fax:603-883-1568
Is Sole Proprietor?:No
Enumeration Date:2015-07-10
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OHC.1902338101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHATN472446Medicaid