Provider Demographics
NPI:1174691091
Name:HANAU, RISA (LCSW)
Entity type:Individual
Prefix:
First Name:RISA
Middle Name:
Last Name:HANAU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6110 MORGAN ASHLEY DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-4033
Mailing Address - Country:US
Mailing Address - Phone:336-292-5528
Mailing Address - Fax:
Practice Address - Street 1:6110 MORGAN ASHLEY DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-4033
Practice Address - Country:US
Practice Address - Phone:336-292-5528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2009-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0008831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical