Provider Demographics
NPI:1649283912
Name:HANNEGAN, SUZANNE R
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:R
Last Name:HANNEGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 ROBINWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216-1030
Mailing Address - Country:US
Mailing Address - Phone:412-343-2542
Mailing Address - Fax:412-661-1304
Practice Address - Street 1:6324 MARCHAND ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4312
Practice Address - Country:US
Practice Address - Phone:412-661-1239
Practice Address - Fax:412-661-1304
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0137801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical