Healthcare Provider Details

I. General information

NPI: 1548040561
Provider Name (Legal Business Name): HADLEY HATTEBERG LPCC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2023
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2639 WOOSTER RD
ROCKY RIVER OH
44116-2911
US

IV. Provider business mailing address

160 W CAMINO REAL # 1223
BOCA RATON FL
33432-5942
US

V. Phone/Fax

Practice location:
  • Phone: 216-250-2043
  • Fax:
Mailing address:
  • Phone: 216-250-2043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2606133
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: