Provider Demographics
NPI:1073057360
Name:HANN, MARIN (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARIN
Middle Name:
Last Name:HANN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 S CREEK DR SE APT 103
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49512-8334
Mailing Address - Country:US
Mailing Address - Phone:248-767-4637
Mailing Address - Fax:
Practice Address - Street 1:3500 BYRON CENTER AVE SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519-3260
Practice Address - Country:US
Practice Address - Phone:616-208-9337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-06
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015815101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional