Hannush, Colleen Rene
Hannush, Colleen Rene is an sole proprietor health care provider with primary practice located at 123 Professional Park Dr Ste 101, Mooresville NC 28117-5516. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Hannush, Colleen Rene can be contacted via phone (866) 588-0977.Contact Information
Primary practice address
123 Professional Park Dr Ste 101
Mooresville NC 28117-5516
Phone: (866) 588-0977
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | C006519 | North Carolina |
Profile Details
| NPI number | 1669648515 |
|---|---|
| LBN Legal business name | Hannush, Colleen Rene |
| Credentials | MSW, LCSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 1st, 2008 |
| Last updated | Dec 13th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669648515 | NPPES |
| North Carolina | Other | 2853453 | MEDICARE PTAN |
| North Carolina | MEDICAID | 6007431 | MEDICARE PTAN |
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