Provider Demographics
NPI:1518474311
Name:HANASKY, BRIAN C (MA)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:C
Last Name:HANASKY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 15TH ST
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-3548
Mailing Address - Country:US
Mailing Address - Phone:304-218-2845
Mailing Address - Fax:304-233-0056
Practice Address - Street 1:87 15TH ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3548
Practice Address - Country:US
Practice Address - Phone:304-218-2845
Practice Address - Fax:304-233-0056
Is Sole Proprietor?:No
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV995103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical