Provider Demographics
NPI:1437408911
Name:HANNAH S. BERENSON, LICSW, INC.
Entity type:Organization
Organization Name:HANNAH S. BERENSON, LICSW, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED INDEPENDENT SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:BERENSON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:413-529-7188
Mailing Address - Street 1:247 NORTHAMPTON STREET
Mailing Address - Street 2:SUITE 11
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027
Mailing Address - Country:US
Mailing Address - Phone:413-529-7188
Mailing Address - Fax:413-529-9937
Practice Address - Street 1:247 NORTHAMPTON STREET
Practice Address - Street 2:SUITE 11
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027
Practice Address - Country:US
Practice Address - Phone:413-529-7188
Practice Address - Fax:413-529-9937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1015700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty