Healthcare Provider Details

I. General information

NPI: 1174509178
Provider Name (Legal Business Name): JEANNE LYNNE HAHN MS, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JEANNE L HAHN-KLUZ MS, LPC, NCC

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 10/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 E SHERIDAN ST SUITE #B
LARAMIE WY
82070-3868
US

IV. Provider business mailing address

1815 ORD ST
LARAMIE WY
82070-4738
US

V. Phone/Fax

Practice location:
  • Phone: 307-760-2683
  • Fax:
Mailing address:
  • Phone: 307-760-2683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number733
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC-733
License Number StateWY
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC - 733
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: