MEDICARE: HANNAH SANII LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	C011763	NC
2	1041C0700X	Clinical Social Worker	C011763	NC

General Provider Information

NPI Number	:	1629524152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH SANII LCSW

Provider Business Mailing Address
First Line	:	202 BELT DR
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28056-9476
Country	:	US
Telephone Number	:	704-800-4203
Fax Number	:

Provider Business Practice Location Address
First Line	:	202 BELT DR
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28056-9476
Country	:	US
Telephone Number	:	704-800-4203
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2016
Last Update Date	:	08/23/2024

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