Healthcare Provider Details

I. General information

NPI: 1407569429
Provider Name (Legal Business Name): HANNAH DEMELLO LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2023
Last Update Date: 01/04/2023
Certification Date: 01/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IOWA LN STE 204
CARY NC
27511-2400
US

IV. Provider business mailing address

159 WALNUT FOREST LN
MORRISVILLE NC
27560-7332
US

V. Phone/Fax

Practice location:
  • Phone: 919-587-8018
  • Fax:
Mailing address:
  • Phone: 828-699-8103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP017897
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: