Provider Demographics
NPI:1689471252
Name:CALLAHAN, HANNAH MICHAEL ICE COOK (LPC)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MICHAEL ICE COOK
Last Name:CALLAHAN
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:MICAHEL
Other - Last Name:ICE-COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 FORESTGLADE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1777
Mailing Address - Country:US
Mailing Address - Phone:320-828-1619
Mailing Address - Fax:
Practice Address - Street 1:1430 COLLIER ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-2911
Practice Address - Country:US
Practice Address - Phone:320-828-1619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89162101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional