Provider Demographics
NPI:1740674134
Name:CONLEY, HANNAH MARIE MECASKEY (MA)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE MECASKEY
Last Name:CONLEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-1425
Mailing Address - Country:US
Mailing Address - Phone:440-991-6623
Mailing Address - Fax:
Practice Address - Street 1:92 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-1425
Practice Address - Country:US
Practice Address - Phone:440-991-6623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1767-MH-B1103K00000X
MA1221401041C0700X
OHS.1400052-TRNE104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty