Basic Information
| Provider Information | |||||||||
| NPI: | 1003149337 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HANAFORD | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | M.ED, LMHC, LCPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19 SYLVAN RD | ||||||||
| Address2: | |||||||||
| City: | SCARBOROUGH | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040748851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9782694347 | ||||||||
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| Practice Location | |||||||||
| Address1: | 57 WINGATE ST UNIT 401 | ||||||||
| Address2: | |||||||||
| City: | HAVERHILL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018325759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9782414908 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2009 | ||||||||
| LastUpdateDate: | 08/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.