Provider Demographics
NPI:1174509178
Name:HAHN, JEANNE LYNNE (MS, LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:LYNNE
Last Name:HAHN
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:JEANNE
Other - Middle Name:L
Other - Last Name:HAHN-KLUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC, NCC
Mailing Address - Street 1:1815 ORD ST
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82070-4738
Mailing Address - Country:US
Mailing Address - Phone:307-760-2683
Mailing Address - Fax:
Practice Address - Street 1:920 E SHERIDAN ST
Practice Address - Street 2:SUITE #B
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-3868
Practice Address - Country:US
Practice Address - Phone:307-760-2683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-21
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY733101YM0800X
WYLPC-733101Y00000X
WYLPC - 733101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY312374OtherBS