MEDICARE: HANNAH WAY LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFTC.0013622	CO

General Provider Information

NPI Number	:	1053889865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH WAY LMFT

Provider Business Mailing Address
First Line	:	924 W JACKSON ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-5934
Country	:	US
Telephone Number	:	860-212-0128
Fax Number	:

Provider Business Practice Location Address
First Line	:	7750 N UNION BLVD STE 202
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-4082
Country	:	US
Telephone Number	:	719-357-8957
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2018
Last Update Date	:	01/02/2019

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Directions to “ HANNAH WAY LMFT” Practice Location

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