Provider Demographics
NPI:1255192217
Name:HANNA, PEGGY MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:MARIE
Last Name:HANNA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:MARIE
Other - Last Name:FALBAUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11719 BEE CAVES RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BEE CAVE
Mailing Address - State:TX
Mailing Address - Zip Code:78738-5540
Mailing Address - Country:US
Mailing Address - Phone:737-237-9136
Mailing Address - Fax:
Practice Address - Street 1:11719 BEE CAVES RD STE 200
Practice Address - Street 2:
Practice Address - City:BEE CAVE
Practice Address - State:TX
Practice Address - Zip Code:78738-5540
Practice Address - Country:US
Practice Address - Phone:737-237-9136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX689891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical