Individual
DR. JOHN JOSEPH HANNIFAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
308 N MULBERRY ST, ELIZABETHTOWN, KY 42701-1846
(270) 765-5043
(270) 769-5654
Mailing address
308 N MULBERRY ST, ELIZABETHTOWN, KY 42701-1846
(270) 765-5043
(270) 769-5654
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
KY0256
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000047088
ANTHEM BC/BS
KY
01
—
022450
HORIZON BEHAVIORAL HEALTH
KY
01
—
036557000
MAGELLAN BEHAVIORAL HEALT
KY
01
—
044662
VALUE OPTIONS
KY
01
—
092987
MANAGED HEALTH NETWORK
KY
01
—
207474
COMP PSYCH
KY
01
—
29101060
IMPACT PLUS-DMH
KY
01
—
29201068
IMPACT PLUS-DCBS
KY
01
—
6135352
UNITED HEALTHCARE
KY
01
—
63617
MENTAL HEALTH NET
KY
01
—
70778
CMG
KY
01
—
77272
CIGNA HEALTH CARE
KY
01
—
873663
USA MANAGED CARE
KY
05
—
89002562
—
KY
01
—
HUKY0729
HUMANA
KY
01
—
PVPB136788
AMERICAN PSYCH SYSTEMS
KY
Enumeration date
12/05/2005
Last updated
08/03/2010
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