MEDICARE: HANNAH JOY BORMAN MA, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	6401224332	MI

General Provider Information

NPI Number	:	1528706421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH JOY BORMAN MA, LPC

Provider Business Mailing Address
First Line	:	3422 BURTON RIDGE RD SE APT D
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-5828
Country	:	US
Telephone Number	:	231-571-8877
Fax Number	:

Provider Business Practice Location Address
First Line	:	4606 PLAINFIELD AVE NE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-1229
Country	:	US
Telephone Number	:	231-571-8877
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2022
Last Update Date	:	11/10/2025

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