Provider Demographics
NPI:1912470436
Name:HANNAH, PATRICIA J (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:HANNAH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 MONMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1561
Mailing Address - Country:US
Mailing Address - Phone:732-686-9427
Mailing Address - Fax:732-508-6098
Practice Address - Street 1:220 MONMOUTH RD
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1561
Practice Address - Country:US
Practice Address - Phone:732-686-9427
Practice Address - Fax:732-508-6098
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058299001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical