Jacquelin Hahn, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C12047 Issued in NM

Practice address

375 S Main St # 322
Moab, UT 84532

Phone

(505) 633-5470

NPI assigned

Oct 2, 2017

Last updated

Mar 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grounded Healing Therapy

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Moab, UT
  • NPI 1033950399

  Clinical

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1316457583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 S MAIN ST # 322",
            "city": "MOAB",
            "state": "UT",
            "postal_code": "845322557",
            "telephone_number": "505-633-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 S MAIN ST # 322",
            "city": "MOAB",
            "state": "UT",
            "postal_code": "84532",
            "telephone_number": "505-633-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAHN",
        "first_name": "JACQUELIN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2022-03-28",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "125905553501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C12047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grand County School District
• Grand County Wellness Center
• Grand Junction Vamc
• Robert Isadore Greenberg, LMHC
• Grounded Healing Therapy
• Kimberly Hansen
• Robert Doyle Hatch, SSW
• Ryan Grant Hayes, O.D.
• Stephanie Nicole Head Hayes, DPT
• Tori Helm, LCSW

• Clinical Social Worker in Moab, UT
• Providers in Moab, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.