Provider Demographics
NPI:1558809111
Name:HAHN, JENNIFER HARTSELL (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HARTSELL
Last Name:HAHN
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 EARLE BROWN DR STE 520
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-4112
Mailing Address - Country:US
Mailing Address - Phone:763-569-0972
Mailing Address - Fax:
Practice Address - Street 1:6120 EARLE BROWN DR STE 520
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-4112
Practice Address - Country:US
Practice Address - Phone:763-569-0972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01432101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health