Individual provider Active NPI

Dianna Severance-Hanna, LCSW-C

  • Clinical Social Worker
  • Easton, MD
National Provider Identifier
1568764579
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
24791 Issued in MD
Practice address
7623 Tred Avon Cir
Easton, MD 21601-8163
Phone
(410) 924-5168
NPI assigned
Nov 23, 2010
Last updated
Mar 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 24791 MD Primary

Addresses

Primary practice location

7623 Tred Avon Cir
Easton, MD 21601-8163

Mailing address

7623 Tred Avon Cir
Easton, MD 21601-8163
Phone (410) 924-5168

Other identifiers 1

IdentifierTypeStateIssuer
609550002MedicaidMD

Other names 1

  • Dee Hanna Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190816001904 MD Practitioner - Clinical Social Worker 4284961061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Peace of Mind Mental Health Services LLCGroup PAC ID 6103047436, 13 clinicians

Practice addresses (Care Compare)

29315 Erickson Dr
Easton, MD 21601-8651
Phone (410) 690-8181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24791MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Mind Mental Health Services LLC Clinical CurrentSince Dec 14, 2021 Accepting new patients

Locations

29315 Erickson Dr
Easton, MD 21601
Phone (410) 690-8181

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1568764579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7623 TRED AVON CIR",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216018163",
            "telephone_number": "410-924-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7623 TRED AVON CIR",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216018163",
            "telephone_number": "410-924-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERANCE-HANNA",
        "first_name": "DIANNA",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-23",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "24791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "609550002",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEE",
            "last_name": "HANNA",
            "credential": "LCSW-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Easton, MD

Sources for this page

Verify at the official NPI Registry.