MEDICARE: HANNAH KATHLEEN MCGRATH MDIV/MA COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	P105418	NY

General Provider Information

NPI Number	:	1093331233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH KATHLEEN MCGRATH MDIV/MA COUNSELING

Provider Business Mailing Address
First Line	:	1469 PACIFIC ST APT 16
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-3236
Country	:	US
Telephone Number	:	215-589-8268
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 COURT ST STE 1210
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11242-1112
Country	:	US
Telephone Number	:	917-727-8437
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2020
Last Update Date	:	06/23/2020

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