Provider Demographics
NPI:1225761521
Name:HADNEY, MARISSA ANNE (MD)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:ANNE
Last Name:HADNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:458 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-2208
Mailing Address - Country:US
Mailing Address - Phone:440-799-3563
Mailing Address - Fax:
Practice Address - Street 1:8251 MAYFIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026-2567
Practice Address - Country:US
Practice Address - Phone:440-490-7226
Practice Address - Fax:833-206-5014
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
88-3084519OtherTHERAPY