Provider Demographics
NPI:1316688278
Name:HENRY, HANNAH ANNE (LPC)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:ANNE
Last Name:HENRY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8621 CASS RIVER DR
Mailing Address - Street 2:
Mailing Address - City:FOWLERVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48836-9061
Mailing Address - Country:US
Mailing Address - Phone:248-535-0205
Mailing Address - Fax:
Practice Address - Street 1:8621 CASS RIVER DR
Practice Address - Street 2:
Practice Address - City:FOWLERVILLE
Practice Address - State:MI
Practice Address - Zip Code:48836-9061
Practice Address - Country:US
Practice Address - Phone:248-535-0205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401222593101YP2500X
MISC0000000831364101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional