Provider Demographics
NPI:1780037093
Name:TOLLEFSON, HANNAH LEIGHAN (MS, LPC, LCDC)
Entity Type:Individual
Prefix:MISS
First Name:HANNAH
Middle Name:LEIGHAN
Last Name:TOLLEFSON
Suffix:
Gender:F
Credentials:MS, LPC, LCDC
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:LIVERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC, LCDC
Mailing Address - Street 1:1203 FORD ST
Mailing Address - Street 2:
Mailing Address - City:LLANO
Mailing Address - State:TX
Mailing Address - Zip Code:78643-2611
Mailing Address - Country:US
Mailing Address - Phone:325-247-4477
Mailing Address - Fax:325-247-5939
Practice Address - Street 1:1203 FORD ST
Practice Address - Street 2:
Practice Address - City:LLANO
Practice Address - State:TX
Practice Address - Zip Code:78643-2611
Practice Address - Country:US
Practice Address - Phone:325-247-4477
Practice Address - Fax:325-247-5939
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-21
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13449101YA0400X
TX76239101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)