Provider Demographics
NPI:1992476360
Name:HAHN, KATHARINE JO (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHARINE
Middle Name:JO
Last Name:HAHN
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 1:16800 VAN AKEN BLVD APT 215
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-3650
Mailing Address - Country:US
Mailing Address - Phone:216-544-0827
Mailing Address - Fax:
Practice Address - Street 1:3401 ENTERPRISE PKWY STE 250
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7343
Practice Address - Country:US
Practice Address - Phone:216-765-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6689103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling