Provider Demographics
NPI:1598647000
Name:HANNA, DANA MARIE (MSW, LSAA)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:MARIE
Last Name:HANNA
Suffix:
Gender:F
Credentials:MSW, LSAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 FULCRUM WAY NE STE B
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-8410
Mailing Address - Country:US
Mailing Address - Phone:505-350-6731
Mailing Address - Fax:505-867-3514
Practice Address - Street 1:4321 FULCRUM WAY NE STE B
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-8410
Practice Address - Country:US
Practice Address - Phone:505-350-6731
Practice Address - Fax:505-867-3514
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2024-0145101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)