Provider Demographics
NPI:1740279322
Name:BERENSON, HANNAH SUE (LICSW)
Entity type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:SUE
Last Name:BERENSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HIGH MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-2625
Mailing Address - Country:US
Mailing Address - Phone:413-586-8804
Mailing Address - Fax:
Practice Address - Street 1:116 PLEASANT ST
Practice Address - Street 2:STE 308
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-2756
Practice Address - Country:US
Practice Address - Phone:413-586-7788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10157001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO7399Medicare UPIN