Active NPI
Tinellya L Hannah, LCSW
- Clinical Social Worker
- Fort Bliss, TX
National Provider Identifier
1356516249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C-07753
- Practice address
- 2487 Carrington Road
Fort Bliss, TX 79906 - Phone
- (915) 742-1615
- NPI assigned
- Apr 23, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C-07753 | NM | Primary |
Addresses
Primary practice location
2487 Carrington Road
Fort Bliss, TX 79906
Mailing address
18511 Highlander Medics St
Fort Bliss, TX 79906-5327
Phone (915) 742-1615
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-07753 | NM | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728950400000",
"number": "1356516249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18511 HIGHLANDER MEDICS ST",
"city": "FORT BLISS",
"state": "TX",
"postal_code": "799065327",
"telephone_number": "915-742-1615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2487 CARRINGTON ROAD",
"city": "FORT BLISS",
"state": "TX",
"postal_code": "79906",
"telephone_number": "915-742-1615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNAH",
"first_name": "TINELLYA",
"middle_name": "L",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-23",
"last_updated": "2024-10-15",
"certification_date": "2024-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "C-07753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Bliss, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.