=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285503383
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HANNAH BROOKE THERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/05/2025
-----------------------------------------------------
Last Update Date | 11/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13738 BURBANK BLVD APT 1
-----------------------------------------------------
City | SHERMAN OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91401-5043
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-394-0943
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13738 BURBANK BLVD APT 1
-----------------------------------------------------
City | SHERMAN OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91401-5043
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-394-0943
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-OWNER/CLINICAL SOCIAL WORKER
-----------------------------------------------------
Name | CARLY NAHIN
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 818-394-0943
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------