Individual provider Active NPI

Valarie Louise Hannemann, PHD

  • Psychologist
  • Flagstaff, AZ
National Provider Identifier
1750416418
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3247 Issued in AZ
Practice address
1851 W Getaway TRL
Flagstaff, AZ 86001-8569
Phone
(928) 214-9187
Fax
(928) 214-9187
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3247 AZ Primary

Addresses

Primary practice location

1851 W Getaway TRL
Flagstaff, AZ 86001-8569

Mailing address

1851 W Getaway TRL
Flagstaff, AZ 86001-8569
Phone (928) 214-9187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20051108000711 AZ Practitioner - Clinical Psychologist 6608894670 Practice locations: Flagstaff, AZ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1851 W Getaway TRL
Flagstaff, AZ 86005-8569
Phone (928) 699-3726

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3247AZMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750416418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 W GETAWAY TRL",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860018569",
            "telephone_number": "928-214-9187",
            "fax_number": "928-214-9187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 W GETAWAY TRL",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860018569",
            "telephone_number": "928-214-9187",
            "fax_number": "928-214-9187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNEMANN",
        "first_name": "VALARIE",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "3247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.