Provider Demographics
NPI:1104397850
Name:NEU, HANNAH LEE
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:LEE
Last Name:NEU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5058 BUFFALO RUN
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-6708
Mailing Address - Country:US
Mailing Address - Phone:419-979-9152
Mailing Address - Fax:
Practice Address - Street 1:299 CRAMER CREEK CT
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-2586
Practice Address - Country:US
Practice Address - Phone:614-889-5722
Practice Address - Fax:614-889-9335
Is Sole Proprietor?:No
Enumeration Date:2018-12-06
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OH390200000X
OHC.2204372101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1473276Medicaid