Provider Demographics
NPI:1891845368
Name:HASSAN, BONNIE J (LSW)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:J
Last Name:HASSAN
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 STEUBEN ST
Mailing Address - Street 2:STE. 100
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-5537
Mailing Address - Country:US
Mailing Address - Phone:412-920-2911
Mailing Address - Fax:412-920-2911
Practice Address - Street 1:139 STEUBEN ST
Practice Address - Street 2:STE. 100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-5537
Practice Address - Country:US
Practice Address - Phone:412-920-2911
Practice Address - Fax:412-920-2911
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW011342L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAHA383906OtherMAGELLAN