Healthcare Provider Details

I. General information

NPI: 1356167225
Provider Name (Legal Business Name): HANNAH JANE MORELAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24100 CHAGRIN BLVD
BEACHWOOD OH
44122-5535
US

IV. Provider business mailing address

5504 TOWBRIDGE DR
HUDSON OH
44236-2605
US

V. Phone/Fax

Practice location:
  • Phone: 800-642-4560
  • Fax:
Mailing address:
  • Phone: 234-380-2736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2406240-TRNE
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2406240-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: