Healthcare Provider Details

I. General information

NPI: 1790622710
Provider Name (Legal Business Name): HANNAH KATHERINE ILIFF LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5521 W LINCOLN HWY STE 101
CROWN POINT IN
46307-1118
US

IV. Provider business mailing address

11011 N 1200 W
DEMOTTE IN
46310-9476
US

V. Phone/Fax

Practice location:
  • Phone: 219-359-3272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number99136107A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: