1992369011 NPI number — DANIEL SEAN HANNON LMFT

Table of content: DANIEL SEAN HANNON LMFT (NPI 1992369011)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992369011 NPI number — DANIEL SEAN HANNON LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANNON
Provider First Name:
DANIEL
Provider Middle Name:
SEAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HANNON
Provider Other First Name:
SEAN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMFT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1992369011
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
911 MONTANA MDWS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78258-3822
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-699-4762
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
314 N AUSTIN ST STE 111
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEGUIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78155-5535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-303-3161
Provider Business Practice Location Address Fax Number:
830-386-0792
Provider Enumeration Date:
04/24/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  202384 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)