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Individual

MS. CARRIE GRACE HANLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
1 HOLLOW LN STE 301, NEW HYDE PARK, NY 11042-1215
(630) 728-6614
Mailing address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(312) 227-0850

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
116106
NY
273R00000X
Psychiatric Hospital Unit
150.105517
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
116106
LICENSED MASTER SOCIAL WORKER
NY
01
150.105517
LICENSED SOCIAL WORKER
IL
Enumeration date
08/24/2022
Last updated
08/26/2022
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