Provider Demographics
NPI:1669801908
Name:HANNAH MIRMIRAN LLC
Entity type:Organization
Organization Name:HANNAH MIRMIRAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:MIRMIRAN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:402-595-8368
Mailing Address - Street 1:6901 DODGE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-2759
Mailing Address - Country:US
Mailing Address - Phone:402-595-8368
Mailing Address - Fax:402-939-0059
Practice Address - Street 1:6901 DODGE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-2759
Practice Address - Country:US
Practice Address - Phone:402-595-8368
Practice Address - Fax:402-939-0059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty