Provider Demographics
NPI:1851724769
Name:HAHN, MOLLY (LMSW)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:HAHN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:292 MAIN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-2572
Mailing Address - Country:US
Mailing Address - Phone:845-709-0700
Mailing Address - Fax:845-675-5070
Practice Address - Street 1:292 MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960
Practice Address - Country:US
Practice Address - Phone:845-709-0700
Practice Address - Fax:845-675-5070
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY08377911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04496897Medicaid