Healthcare Provider Details

I. General information

NPI: 1710157060
Provider Name (Legal Business Name): HOPE S HANRON LCPC; LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2008
Last Update Date: 06/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 FOREST AVE
PORTLAND ME
04101-2015
US

IV. Provider business mailing address

95 PARKER ST
NEWBURYPORT MA
01950-4033
US

V. Phone/Fax

Practice location:
  • Phone: 207-730-8270
  • Fax: 978-225-2251
Mailing address:
  • Phone: 978-225-2250
  • Fax: 978-225-2251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAC2954
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC2701
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: