Healthcare Provider Details

I. General information

NPI: 1215743281
Provider Name (Legal Business Name): HANNAH DOWNING LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH GALLEE

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 JACOBSSEN DR
NORMAL IL
61761-6277
US

IV. Provider business mailing address

2806 ESSINGTON ST
BLOOMINGTON IL
61705-6532
US

V. Phone/Fax

Practice location:
  • Phone: 309-451-8888
  • Fax:
Mailing address:
  • Phone: 224-558-4118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.027921
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: