Provider Demographics
NPI:1386998458
Name:FESTA-HANNA, JUDY E (LPC, CACII)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:E
Last Name:FESTA-HANNA
Suffix:
Gender:F
Credentials:LPC, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1038 BLACKBOTTOM RD.
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:SC
Mailing Address - Zip Code:29657
Mailing Address - Country:US
Mailing Address - Phone:864-360-2910
Mailing Address - Fax:
Practice Address - Street 1:226 MCGEE ROAD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625
Practice Address - Country:US
Practice Address - Phone:864-260-4168
Practice Address - Fax:864-261-7543
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1209174101YA0400X
SC3464101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)