Mitchell B. Hannafius, LMSW
Individual provider Active NPI Clinical Social Worker · Cassopolis, MI
NPI 1689872913 · NPPES record last updated Nov 4, 2015
Key facts
- NPI
- 1689872913
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6801089466 (MI)
- Practice address
- 261 M 62
Cassopolis, MI 49031-1034 - Phone
- (269) 445-3874
- Fax
- (269) 445-2076
- NPI assigned
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33004521A | IN | MD | Clinical Social Worker |
| 6801089466 | MI | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801089466 | MI | Yes |
| Clinical Social Worker | 1041C0700X | 33004521A | IN |
Addresses
Primary practice location
261 M 62
Cassopolis, MI 49031-1034
Mailing address
2415 Burton Rd
Niles, MI 49120-9203
Phone (269) 591-2360
Other providers in Cassopolis, MI
- Melissa S. Freer-Smith
- Sara Gibson
- Brenda Haffner
- Emma K Halicki
- Laura Kaye Hamdani
- Glenda McMillen Hass
- John Edwin Hayman Jr.
- Dawna Mist Heiliger
- Mike Hewlett
- Joni K Hodge
All providers in Cassopolis, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.