Provider Demographics
NPI:1700952066
Name:COHEN, HANNA (PHD)
Entity Type:Individual
Prefix:DR
First Name:HANNA
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9102 N MERIDIAN ST
Mailing Address - Street 2:STE 525
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1898
Mailing Address - Country:US
Mailing Address - Phone:317-574-1157
Mailing Address - Fax:317-580-0509
Practice Address - Street 1:9102 N MERIDIAN ST
Practice Address - Street 2:STE 525
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1898
Practice Address - Country:US
Practice Address - Phone:317-574-1157
Practice Address - Fax:317-580-0509
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN350006151041C0700X
IN34002149106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN248380Medicare ID - Type Unspecified