Provider Demographics
NPI:1659907368
Name:MARTIN, HANNAH BLAIR (SWC)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:BLAIR
Last Name:MARTIN
Suffix:
Gender:
Credentials:SWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 STOVER ST BLDG C
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4641
Mailing Address - Country:US
Mailing Address - Phone:970-942-3031
Mailing Address - Fax:
Practice Address - Street 1:2550 STOVER ST BLDG C
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4641
Practice Address - Country:US
Practice Address - Phone:970-942-3031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-14
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X, 171M00000X
COSWC.00000024401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator