Provider Demographics
NPI:1013518737
Name:ELLIOTT, HANNAH (LCSW)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:O'NEIL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:343 S MAIN ST STE 211
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-2138
Mailing Address - Country:US
Mailing Address - Phone:913-980-0170
Mailing Address - Fax:
Practice Address - Street 1:14086 TUPPER LAKE WAY
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:MI
Practice Address - Zip Code:48451-8470
Practice Address - Country:US
Practice Address - Phone:913-980-0170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10836362-35011041C0700X
MI68011152781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical