Provider Demographics
NPI:1366124729
Name:HASS, MADISEN DAWN (CMHC)
Entity type:Individual
Prefix:
First Name:MADISEN
Middle Name:DAWN
Last Name:HASS
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 7TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KASSON
Mailing Address - State:MN
Mailing Address - Zip Code:55944-1574
Mailing Address - Country:US
Mailing Address - Phone:320-980-1058
Mailing Address - Fax:
Practice Address - Street 1:104 7TH AVE NE
Practice Address - Street 2:
Practice Address - City:KASSON
Practice Address - State:MN
Practice Address - Zip Code:55944-1574
Practice Address - Country:US
Practice Address - Phone:320-980-1058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health