Provider Demographics
NPI:1821127291
Name:HANNA, BARBARA KATHERINE (LCSW, PHD, BCD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:KATHERINE
Last Name:HANNA
Suffix:
Gender:F
Credentials:LCSW, PHD, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 BAY AVE
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:ME
Mailing Address - Zip Code:04640-4003
Mailing Address - Country:US
Mailing Address - Phone:207-422-4772
Mailing Address - Fax:207-422-4772
Practice Address - Street 1:35 EASTWARD LN
Practice Address - Street 2:SUITE 1
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1744
Practice Address - Country:US
Practice Address - Phone:207-460-3339
Practice Address - Fax:207-422-4772
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC57051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical