Provider Demographics
NPI:1568684553
Name:HANAWALT, MICHAEL STEVEN (MA, NCC, LPC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:STEVEN
Last Name:HANAWALT
Suffix:
Gender:M
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 MACE STREET
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6643
Mailing Address - Country:US
Mailing Address - Phone:724-837-5853
Mailing Address - Fax:
Practice Address - Street 1:FOURTH STREET SQUARE
Practice Address - Street 2:105 WEST FOURTH STREET
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-6643
Practice Address - Country:US
Practice Address - Phone:724-834-7830
Practice Address - Fax:724-834-8395
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002934101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional