Provider Demographics
NPI:1962875302
Name:HANSEN, HANNAH (LISW)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:HANSEN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 COMMERCE PKWY APT 305
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-8962
Mailing Address - Country:US
Mailing Address - Phone:216-246-3097
Mailing Address - Fax:
Practice Address - Street 1:265 BENEDICT AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-2308
Practice Address - Country:US
Practice Address - Phone:419-219-9776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-06
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS. 1502377104100000X
OHI.22040641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker