Provider Demographics
NPI:1174295034
Name:DISMER, HANNAH (LCSW, MSW, MPH, CSE)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:DISMER
Suffix:
Gender:F
Credentials:LCSW, MSW, MPH, CSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 21ST ST
Mailing Address - Street 2:
Mailing Address - City:GRANITE CITY
Mailing Address - State:IL
Mailing Address - Zip Code:62040-5397
Mailing Address - Country:US
Mailing Address - Phone:618-451-5722
Mailing Address - Fax:618-451-9092
Practice Address - Street 1:1602 21ST ST
Practice Address - Street 2:
Practice Address - City:GRANITE CITY
Practice Address - State:IL
Practice Address - Zip Code:62040-5397
Practice Address - Country:US
Practice Address - Phone:618-451-5722
Practice Address - Fax:618-451-9092
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490237851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical