Provider Demographics
NPI:1811013790
Name:HANNANT, STEVEN N (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:N
Last Name:HANNANT
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 WOOTEN BLVD SW
Mailing Address - Street 2:SUITE K
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4464
Mailing Address - Country:US
Mailing Address - Phone:252-291-0735
Mailing Address - Fax:252-291-2890
Practice Address - Street 1:2401 WOOTEN BLVD SW
Practice Address - Street 2:SUITE K
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4464
Practice Address - Country:US
Practice Address - Phone:252-291-0735
Practice Address - Fax:252-291-2890
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3681103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6001132Medicaid