Healthcare Provider Details

I. General information

NPI: 1851016067
Provider Name (Legal Business Name): HASAN HEALTH HOLISTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5330 DIJON DR
BATON ROUGE LA
70808-7214
US

IV. Provider business mailing address

5330 DIJON DR
BATON ROUGE LA
70808-7214
US

V. Phone/Fax

Practice location:
  • Phone: 773-574-4328
  • Fax:
Mailing address:
  • Phone: 773-574-4328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: RANYA HASAN
Title or Position: CEO
Credential: LCPC
Phone: 773-574-4328