Healthcare Provider Details

I. General information

NPI: 1316836026
Provider Name (Legal Business Name): HANNAH HOLLINGSWORTH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 SUMMER ST
MARTIN TN
38237-3037
US

IV. Provider business mailing address

115 SUMMER ST
MARTIN TN
38237-3037
US

V. Phone/Fax

Practice location:
  • Phone: 731-431-4730
  • Fax:
Mailing address:
  • Phone: 731-431-4730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6964
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: