Healthcare Provider Details

I. General information

NPI: 1740025915
Provider Name (Legal Business Name): HANNAH CATHERINE OSHIELDS LMSW
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2024
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E GREEN ST
ITHACA NY
14850-5635
US

IV. Provider business mailing address

201 E GREEN ST
ITHACA NY
14850-5635
US

V. Phone/Fax

Practice location:
  • Phone: 607-274-6200
  • Fax:
Mailing address:
  • Phone: 607-274-6200
  • Fax: 607-220-4795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number124570
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: