Provider Demographics
NPI:1205477262
Name:TITTERINGTON, HANNAH (LMSW)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:TITTERINGTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 N MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1250
Mailing Address - Country:US
Mailing Address - Phone:734-335-0028
Mailing Address - Fax:
Practice Address - Street 1:340 N MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1250
Practice Address - Country:US
Practice Address - Phone:734-335-0028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-01
Last Update Date:2023-12-06
Deactivation Date:2020-09-23
Deactivation Code:
Reactivation Date:2020-09-30
Provider Licenses
StateLicense IDTaxonomies
MI6801108042104100000X
OHS.190111-TRNE390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program