Provider Demographics
NPI:1033692462
Name:BLOCH, HANNAH (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:BLOCH
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GREGORY LN
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-2255
Mailing Address - Country:US
Mailing Address - Phone:978-635-1648
Mailing Address - Fax:
Practice Address - Street 1:2 GREGORY LN
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-2255
Practice Address - Country:US
Practice Address - Phone:978-635-1648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10227011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1022701OtherCOMMONWEALTH OF MA, DIV. OF PROFESSIONAL LICENSURE