Provider Demographics
NPI:1144825829
Name:HANNA PSYCHOTHERAPY PLLC
Entity type:Organization
Organization Name:HANNA PSYCHOTHERAPY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:L
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:206-317-4570
Mailing Address - Street 1:11831 OLYMPIC TERRACE AVE NE
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-4293
Mailing Address - Country:US
Mailing Address - Phone:708-707-1929
Mailing Address - Fax:708-406-1532
Practice Address - Street 1:175 PARFITT WAY SW STE N280
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-4926
Practice Address - Country:US
Practice Address - Phone:206-317-4570
Practice Address - Fax:708-406-1532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-01
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty