Hannah Elissa Fordham, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC012122 Issued in GA

Practice address

106 E 2ND St
Vidalia, GA 30474-4709

Phone

(912) 585-5504

Fax

(912) 525-3026

NPI assigned

May 27, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1780250019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 765",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304750765",
            "telephone_number": "912-585-5504",
            "fax_number": "912-525-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E 2ND ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304744709",
            "telephone_number": "912-585-5504",
            "fax_number": "912-525-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORDHAM",
        "first_name": "HANNAH",
        "middle_name": "ELISSA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC012122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hfordham@lawhite.net",
            "affiliation": "N",
            "endpointDescription": "hfordham@lawhite.net",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "106 E 2nd St",
            "city": "Vidalia",
            "state": "GA",
            "country_code": "US",
            "postal_code": "304744709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Professional Counselor in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.