Provider Demographics
NPI:1720232994
Name:HANNAN, EMILY DIXON (LCSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:DIXON
Last Name:HANNAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LEE
Other - Middle Name:DIXON
Other - Last Name:HANNAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:4 CORNERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1314
Mailing Address - Country:US
Mailing Address - Phone:215-757-6916
Mailing Address - Fax:
Practice Address - Street 1:4 CORNERSTONE DR
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1314
Practice Address - Country:US
Practice Address - Phone:215-757-6916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0157481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical