Provider Demographics
NPI:1790365591
Name:JETER, HANNAH (NCMHCA)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:JETER
Suffix:
Gender:F
Credentials:NCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 S BUCHANAN BLVD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-2810
Mailing Address - Country:US
Mailing Address - Phone:832-289-8681
Mailing Address - Fax:
Practice Address - Street 1:504 S BUCHANAN BLVD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-2810
Practice Address - Country:US
Practice Address - Phone:832-289-8681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional