MEDICARE: EMILY HANLON

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1912835521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY HANLON

Provider Business Mailing Address
First Line	:	9324 KREUTER RD NE
Second Line	:
City	:	ROCKFORD
State	:	MI
Zip	:	49341-9025
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4630 PLAINFIELD AVE NE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-1643
Country	:	US
Telephone Number	:	616-889-1404
Fax Number	:

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

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

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Directions to “ EMILY HANLON ” Practice Location

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