Provider Demographics
NPI:1669780458
Name:HAHN, MARY-EILEEN (MS)
Entity type:Individual
Prefix:
First Name:MARY-EILEEN
Middle Name:
Last Name:HAHN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 N JEFFERSON ST
Mailing Address - Street 2:SUITE 403
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-3500
Mailing Address - Country:US
Mailing Address - Phone:301-620-8700
Mailing Address - Fax:301-620-8710
Practice Address - Street 1:10 N JEFFERSON ST
Practice Address - Street 2:SUITE 403
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-3500
Practice Address - Country:US
Practice Address - Phone:301-620-8700
Practice Address - Fax:301-620-8710
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3554101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health