Provider Demographics
NPI:1730330473
Name:HANNAH, LAUREN (LCSW)
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:
Last Name:HANNAH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3308 ABIGAIL COURT
Mailing Address - Street 2:NULL
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-7213
Mailing Address - Country:US
Mailing Address - Phone:870-273-3980
Mailing Address - Fax:870-972-4911
Practice Address - Street 1:533 W WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-2782
Practice Address - Country:US
Practice Address - Phone:870-229-0302
Practice Address - Fax:870-972-4911
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR6677-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR229134719Medicaid
AR1730330473OtherBCBS