Provider Demographics
NPI:1093985327
Name:HAHN, NELLA (LMSW)
Entity Type:Individual
Prefix:
First Name:NELLA
Middle Name:
Last Name:HAHN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:NELLA
Other - Middle Name:
Other - Last Name:HAHN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:500 PLEASURE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-4924
Mailing Address - Country:US
Mailing Address - Phone:631-603-8388
Mailing Address - Fax:631-369-9819
Practice Address - Street 1:500 PLEASURE DR
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-4924
Practice Address - Country:US
Practice Address - Phone:631-603-8388
Practice Address - Fax:631-369-9819
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0713881041C0700X
NY0769601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical