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NPI Code Detail

MEDICARE: HANNAH GRACE PREVATT MS, ED.S, LCMHC, NCC

MEDICARE: HANNAH GRACE PREVATT MS, ED.S, LCMHC, NCC
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
1101YM0800XMental Health Counselor14238NC
2101Y00000XCounselorA14238NC

General Provider Information

NPI Number : 1205316981
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH GRACE PREVATT MS, ED.S, LCMHC, NCC
Provider Business Mailing Address
First Line : 836 REGENTS CENTER CIR
Second Line :
City : LEXINGTON
State : NC
Zip : 27295-8618
Country : US
Telephone Number : 910-467-5369
Fax Number :
Provider Business Practice Location Address
First Line : 905 FRIEDBERG CHURCH RD
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27127-9803
Country : US
Telephone Number : 336-251-1180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2018
Last Update Date : 03/01/2022

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