MEDICARE: MS. HANNAH SUE BERENSON LICSW

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	1041C0700X	Clinical Social Worker	1015700	MA

General Provider Information

NPI Number	:	1740279322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HANNAH SUE BERENSON LICSW

Provider Business Mailing Address
First Line	:	1 HIGH MEADOW RD
Second Line	:
City	:	FLORENCE
State	:	MA
Zip	:	01062-2625
Country	:	US
Telephone Number	:	413-586-8804
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 PLEASANT ST
Second Line	:	STE 308
City	:	EASTHAMPTON
State	:	MA
Zip	:	01027-2756
Country	:	US
Telephone Number	:	413-586-7788
Fax Number	:

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

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	08/18/2017

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