Healthcare Provider Details

I. General information

NPI: 1629909601
Provider Name (Legal Business Name): HASSANAT WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 COURT ST
AUBURN ME
04210-3903
US

IV. Provider business mailing address

5 ROLAND AVE
LEWISTON ME
04240-4719
US

V. Phone/Fax

Practice location:
  • Phone: 207-241-1810
  • Fax:
Mailing address:
  • Phone: 207-241-1810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SAHRO Y HASSAN
Title or Position: MENTAL HEALTH COUNSELOR
Credential: MS,LCPC-C
Phone: 207-241-1810