Provider Demographics
NPI:1891877999
Name:HANNA, LORA S (LISW)
Entity Type:Individual
Prefix:MS
First Name:LORA
Middle Name:S
Last Name:HANNA
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 OAKSTONE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-7612
Mailing Address - Country:US
Mailing Address - Phone:614-264-0355
Mailing Address - Fax:
Practice Address - Street 1:2525 OAKSTONE DR
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-7612
Practice Address - Country:US
Practice Address - Phone:614-264-0355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00077491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHHASW27881Medicare ID - Type UnspecifiedMEDICARE NUMBER