Healthcare Provider Details

I. General information

NPI: 1972118412
Provider Name (Legal Business Name): HANNAH COLEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2020
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6655 SANTA BARBARA RD
ELKRIDGE MD
21075-7500
US

IV. Provider business mailing address

6655 SANTA BARBARA RD UNIT 8574
ELKRIDGE MD
21075-7523
US

V. Phone/Fax

Practice location:
  • Phone: 866-610-0580
  • Fax:
Mailing address:
  • Phone: 866-968-6342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: