Provider Demographics
NPI:1215402854
Name:CALVERT, HANNAH MARIE (CDCA)
Entity Type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:MARIE
Last Name:CALVERT
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1088 WASSERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-1974
Mailing Address - Country:US
Mailing Address - Phone:513-735-8100
Mailing Address - Fax:
Practice Address - Street 1:4428 STATE ROUTE 222
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-9777
Practice Address - Country:US
Practice Address - Phone:513-735-8391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.166001101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)