Provider Demographics
NPI:1861014979
Name:HANNA, ISABELLA NEMATALLA (LCSW)
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:NEMATALLA
Last Name:HANNA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ISABELLA
Other - Middle Name:
Other - Last Name:NEMATALLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:80 SEYMOUR ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06102-8000
Mailing Address - Country:US
Mailing Address - Phone:860-972-5092
Mailing Address - Fax:
Practice Address - Street 1:80 SEYMOUR ST # JB111
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06102-8000
Practice Address - Country:US
Practice Address - Phone:860-972-5092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical