Healthcare Provider Details

I. General information

NPI: 1639862261
Provider Name (Legal Business Name): HANNAH ALLEN LPC-MSHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2023
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VANTAGE WAY STE E130
NASHVILLE TN
37228-1591
US

IV. Provider business mailing address

4805 CONCORD DR
HERMITAGE TN
37076-1506
US

V. Phone/Fax

Practice location:
  • Phone: 615-988-4763
  • Fax:
Mailing address:
  • Phone: 615-772-5772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6433
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: