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General NPI Number Information
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NPI Number | 1992224133
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Entity Type | Individual
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Provider Name | MELISSA L HANNAFORD LICDC/LPC
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Gender | Female
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Dates
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Enumeration Date | 09/19/2017
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Last Update Date | 09/19/2017
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Provider Practice Location Address
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Address Line | 1090 W SOUTH BOUNDARY ST STE 600
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City | PERRYSBURG
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State | OH
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Zip | 43551-5249
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Country | US
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Telephone | 419-873-8320
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Fax | 419-330-5115
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Provider Business Mailing Address
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Address Line | 885 COMMERCE DR
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City | PERRYSBURG
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State | OH
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Zip | 43551-5267
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Country | US
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Telephone | 419-330-1050
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.1600414
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LICDC.161545
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License Number State | OH
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