Provider Demographics
NPI:1699024018
Name:HAGMAN, NANCY S (LMHC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:S
Last Name:HAGMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 N 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-4008
Mailing Address - Country:US
Mailing Address - Phone:850-595-5817
Mailing Address - Fax:850-595-5819
Practice Address - Street 1:3401 N 12TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-4008
Practice Address - Country:US
Practice Address - Phone:850-595-5817
Practice Address - Fax:850-595-5819
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 6303101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health