Basic Information
| Provider Information | |||||||||
| NPI: | 1093144586 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HANLON | ||||||||
| FirstName: | CONSTANCE | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSW, LGSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 1200 FIRST STREET, N.E. 9TH FLOOR | ||||||||
| Address2: | DISTRICT OF COLUMBIA PUBLIC SCHOOLS - CHEC M.S. | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 20002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024424800 | ||||||||
| FaxNumber: | 2024425026 | ||||||||
| Practice Location | |||||||||
| Address1: | 3101 16TH STREET N.W. LINCOLN MIDDLE SCHOOL | ||||||||
| Address2: | COLUMBIA HEIGHTS EDUCATIONAL CAMPUS | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 20001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2029396680 | ||||||||
| FaxNumber: | 2025739147 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2013 | ||||||||
| LastUpdateDate: | 11/05/2013 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041S0200X | LG100825 | DC | Y | Behavioral Health & Social Service Providers | Social Worker | School |
No ID Information.