Healthcare Provider Details

I. General information

NPI: 1063053742
Provider Name (Legal Business Name): MAUREEN CASON HANLON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2019
Last Update Date: 01/02/2021
Certification Date: 01/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 NH ROUTE 16A
INTERVALE NH
03845-6300
US

IV. Provider business mailing address

PO BOX 1188
NORTH CONWAY NH
03860-1188
US

V. Phone/Fax

Practice location:
  • Phone: 603-730-5722
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. MAUREEN CASON HANLON
Title or Position: OWNER
Credential: LICSW
Phone: 603-986-5099