David Paul Hanlon, LICDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

923361 Issued in NY

Practice address

9083 Mentor Ave
Mentor, OH 44060-6462

Phone

(440) 255-0678

NPI assigned

Jan 2, 2013

Last updated

Jan 2, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake-Geauga Recovery Centers, Inc.

  • Substance Abuse Rehabilitation Facility
  • Mentor, OH
  • NPI 1750489779
  NPD (past)

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

{
    "created_epoch": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1336485804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9083 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440606462",
            "telephone_number": "440-255-0678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9083 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440606462",
            "telephone_number": "440-255-0678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANLON",
        "first_name": "DAVID",
        "middle_name": "PAUL",
        "credential": "LICDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-02",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "923361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2864664",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2847334",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thyeis Marie Halley
• Drake Hambleton
• Madelyn Hamilton
• Hands on Physical Therapy of Mentor, LLC
• Alyssa Hankins
• Deborah Marie Hanna, LSW
• Brooke Hanzel
• Carrie Happ-Smith, M.D.
• Megan Harber
• Taylor R. Harding, MA

• Addiction (Substance Use Disorder) Counselor in Mentor, OH
• Providers in Mentor, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.