Provider Demographics
NPI:1295404325
Name:BLAHA, HANNAH (MS, LPCC)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:BLAHA
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 GRANDVIEW AVE W APT 258
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-4789
Mailing Address - Country:US
Mailing Address - Phone:952-454-0576
Mailing Address - Fax:
Practice Address - Street 1:245 RUTH ST N STE 101
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55119-4409
Practice Address - Country:US
Practice Address - Phone:651-955-4633
Practice Address - Fax:651-440-9827
Is Sole Proprietor?:No
Enumeration Date:2021-09-11
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101YP2500X
MN4067101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional