Provider Demographics
NPI:1700508488
Name:FEGHALY, HANNAH ELISABETH (LMSW/RCSWI)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:ELISABETH
Last Name:FEGHALY
Suffix:
Gender:F
Credentials:LMSW/RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7524 SOUTHSIDE BLVD APT 1202
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0402
Mailing Address - Country:US
Mailing Address - Phone:865-617-9860
Mailing Address - Fax:
Practice Address - Street 1:1951 NW 7TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1112
Practice Address - Country:US
Practice Address - Phone:305-902-6347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
17564104100000X
TN13768104100000X
FL17564104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker