Keith William Hannan, PH.D.
Individual provider Active NPI Clinical Psychologist · Clarksville, MD
NPI 1093758591 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1093758591
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 02666 (MD)
- Practice address
- 12037 Floating Clouds Path
Clarksville, MD 21029-1678 - Phone
- (410) 707-0100
- NPI assigned
- Jun 13, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02666 | MD | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 02666 | MD | Yes |
Addresses
Primary practice location
12037 Floating Clouds Path
Clarksville, MD 21029-1678
Mailing address
12037 Floating Clouds Path
Clarksville, MD 21029-1678
Phone (410) 707-0100
Other providers in Clarksville, MD
- Cindy Terlonge Graham
- Claire Althea Green
- Suzanne Michelle Guerzon
- H Herbert Benavent DDS PA
- Zakkiyya Hallenbeck
- Rochelle Hanson
- Teresa Mary Heitzmann
- Erika Leigh Hempey
- David Heppel
- James N Hess Jr.
All providers in Clarksville, MD · Clinical Psychologist in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.