1790351971 NPI number — HANNAH ELIZABETH FELICIANO LMFT

Table of content: HANNAH ELIZABETH FELICIANO LMFT (NPI 1790351971)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790351971 NPI number — HANNAH ELIZABETH FELICIANO LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FELICIANO
Provider First Name:
HANNAH
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MENDEZ
Provider Other First Name:
HANNAH
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1790351971
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11443 NEW ZION RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHRISTIANA
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37037-5201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-601-1387
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MURFREESBORO
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37130-3729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-601-1387
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/28/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  1598 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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