Provider Demographics
NPI:1831654912
Name:DEHAAS, ADRIENNE (MA, MSW)
Entity Type:Individual
Prefix:MS
First Name:ADRIENNE
Middle Name:
Last Name:DEHAAS
Suffix:
Gender:F
Credentials:MA, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 MARTHA AVE
Mailing Address - Street 2:
Mailing Address - City:HOPWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15445-2103
Mailing Address - Country:US
Mailing Address - Phone:724-984-3585
Mailing Address - Fax:
Practice Address - Street 1:139 MARTHA AVE
Practice Address - Street 2:
Practice Address - City:HOPWOOD
Practice Address - State:PA
Practice Address - Zip Code:15445-2103
Practice Address - Country:US
Practice Address - Phone:724-984-3585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW135824104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty