Provider Demographics
NPI:1386300663
Name:MEESALA, HANNAH LERAE (LMSW-T)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:LERAE
Last Name:MEESALA
Suffix:
Gender:F
Credentials:LMSW-T
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:LERAE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 N RURAL RD APT 1065
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-6090
Mailing Address - Country:US
Mailing Address - Phone:304-888-6711
Mailing Address - Fax:
Practice Address - Street 1:900 N RURAL RD APT 1065
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-6090
Practice Address - Country:US
Practice Address - Phone:304-888-6711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-7079T104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker