Healthcare Provider Details

I. General information

NPI: 1811523962
Provider Name (Legal Business Name): COURTNEY HASSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2020
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5118 CROOKSHANK RD
CINCINNATI OH
45238-3304
US

IV. Provider business mailing address

5118 CROOKSHANK RD
CINCINNATI OH
45238-3304
US

V. Phone/Fax

Practice location:
  • Phone: 513-435-0379
  • Fax:
Mailing address:
  • Phone: 513-435-0279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCDCII.162148
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: