Provider Demographics
NPI:1548576788
Name:HELLANE, SALLY ANN (MSW)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:ANN
Last Name:HELLANE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4255 KITTREDGE ST
Mailing Address - Street 2:UNIT 1112
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-5702
Mailing Address - Country:US
Mailing Address - Phone:301-730-6406
Mailing Address - Fax:
Practice Address - Street 1:1190 MOUNT AETNA RD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6833
Practice Address - Country:US
Practice Address - Phone:301-730-6406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.000018021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical