Provider Demographics
NPI:1952072548
Name:WHALEN, HANNAH MARIE (CADC)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE
Last Name:WHALEN
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16
Mailing Address - Street 2:
Mailing Address - City:GOULDSBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04607-0016
Mailing Address - Country:US
Mailing Address - Phone:207-266-8327
Mailing Address - Fax:207-664-1800
Practice Address - Street 1:53 CHURCH ST
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1915
Practice Address - Country:US
Practice Address - Phone:207-664-1500
Practice Address - Fax:207-664-1800
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC7721101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)