Provider Demographics
NPI:1093028276
Name:COSDON, HANNAH MALKA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:MALKA
Last Name:COSDON
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 1:448 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2502
Mailing Address - Country:US
Mailing Address - Phone:814-336-1265
Mailing Address - Fax:814-333-1262
Practice Address - Street 1:448 NORTH ST
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-2502
Practice Address - Country:US
Practice Address - Phone:814-336-1265
Practice Address - Fax:814-333-1262
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0165071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACW016507OtherSTATE LICENSE