Healthcare Provider Details

I. General information

NPI: 1659210599
Provider Name (Legal Business Name): HANNAH FREY TAL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH FREY BURKHARD

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9228 GEORGE WASHINGTON MEMORIAL HWY
GLOUCESTER VA
23061-4162
US

IV. Provider business mailing address

111 WHISPERING WAY
YORKTOWN VA
23692-3070
US

V. Phone/Fax

Practice location:
  • Phone: 804-693-5057
  • Fax:
Mailing address:
  • Phone: 757-968-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904020112
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: