Provider Demographics
NPI:1962179077
Name:SALMON, HANNAH MARIE (CDCA, MA)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE
Last Name:SALMON
Suffix:
Gender:F
Credentials:CDCA, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1766 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-1942
Mailing Address - Country:US
Mailing Address - Phone:614-816-1217
Mailing Address - Fax:
Practice Address - Street 1:1815 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-7000
Practice Address - Country:US
Practice Address - Phone:330-247-8277
Practice Address - Fax:330-234-9286
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-26
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.171964101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0457029Medicaid