Provider Demographics
NPI:1558092775
Name:SUTTON-HANNAH, JENNIFER RENEE (LCSW-A, LCAS-A)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RENEE
Last Name:SUTTON-HANNAH
Suffix:
Gender:F
Credentials:LCSW-A, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 5TH AVE E
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-4377
Mailing Address - Country:US
Mailing Address - Phone:828-692-4289
Mailing Address - Fax:828-696-1794
Practice Address - Street 1:1207 EAST ST
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-3438
Practice Address - Country:US
Practice Address - Phone:828-456-2997
Practice Address - Fax:828-456-2996
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0182101041C0700X
NCLCAS-28893101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)