Provider Demographics
NPI:1952172660
Name:DERRIG, HANNA MCINTOSH (LMSW)
Entity Type:Individual
Prefix:
First Name:HANNA
Middle Name:MCINTOSH
Last Name:DERRIG
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 QUINCY ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-1349
Mailing Address - Country:US
Mailing Address - Phone:631-204-7829
Mailing Address - Fax:
Practice Address - Street 1:151 QUINCY ST APT 2A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-1349
Practice Address - Country:US
Practice Address - Phone:631-204-7829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120133104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker