George Ivar Hannibal, LCSW, CADCI

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

01-11-26 Issued in OR

Practice address

1419 NE 69TH Ave
Portland, OR 97213-5301

Phone

(503) 254-1545

Fax

(503) 525-2846

NPI assigned

May 11, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• George I. Hannibal

  • Community/Behavioral Health Agency
  • Portland, OR
  • NPI 1578847737
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1003866708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 NE 69TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972135301",
            "telephone_number": "503-254-1545",
            "fax_number": "503-525-2846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 NE 69TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972135301",
            "telephone_number": "503-254-1545",
            "fax_number": "503-525-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNIBAL",
        "first_name": "GEORGE",
        "middle_name": "IVAR",
        "credential": "LCSW, CADCI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L0525",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "01-11-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Dwight Hannah
• Melanie Lynne Hannah, LCSW
• Heather A Hannam, PT
• Tarver Hannant
• Hannibal & Hannibal, LLC
• Heather Carissa Hannigan, LE
• Stephen J Hanns, DMD
• Macaelan Collins Hanrahan, DMD
• Sherry Gay Hanrahan, LMSW
• Harjap Kaur Hans, RN

• Addiction (Substance Use Disorder) Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.