Provider Demographics
NPI:1912117722
Name:HASSAN, LINDA M (PHD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:M
Last Name:HASSAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 SOUTH MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-4862
Mailing Address - Country:US
Mailing Address - Phone:603-224-1020
Mailing Address - Fax:603-224-1020
Practice Address - Street 1:28 SOUTH MAIN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4862
Practice Address - Country:US
Practice Address - Phone:603-224-1020
Practice Address - Fax:603-224-1020
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH634103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0600998Y0NH01OtherANTHEM BCBS
NH1040259OtherCIGNA BEHAVIORAL HEALTH
NH30005074Medicaid
NHRE3376Medicare ID - Type Unspecified