MEDICARE: MRS. HANNAH LERAE MEESALA LMSW

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	104100000X	Social Worker	LMSW-20178	AZ

General Provider Information

NPI Number	:	1386300663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HANNAH LERAE MEESALA LMSW

Provider Business Mailing Address
First Line	:	4001 N 3RD ST STE 420
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85012-2086
Country	:	US
Telephone Number	:	304-888-6711
Fax Number	:

Provider Business Practice Location Address
First Line	:	4001 N 3RD ST STE 420
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85012-2086
Country	:	US
Telephone Number	:	602-768-6374
Fax Number	:

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

Provider Enumeration Date	:	11/11/2021
Last Update Date	:	09/21/2025

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