Provider Demographics
NPI:1033650676
Name:VAN HANNAK, JOSEPH ALLEN (LPC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ALLEN
Last Name:VAN HANNAK
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:ALLEN
Other - Last Name:HANNAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9153 ROUTE 286 HWY W
Mailing Address - Street 2:
Mailing Address - City:HOMER CITY
Mailing Address - State:PA
Mailing Address - Zip Code:15748-9321
Mailing Address - Country:US
Mailing Address - Phone:773-301-2330
Mailing Address - Fax:
Practice Address - Street 1:1052 OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-2657
Practice Address - Country:US
Practice Address - Phone:724-422-1808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-15
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA009346101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional