Provider Demographics
NPI:1023623816
Name:TINNIN, HANNAH RACHELLE (LPC)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:RACHELLE
Last Name:TINNIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:RACHELLE
Other - Last Name:CONWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:209 N COWLING ST
Mailing Address - Street 2:
Mailing Address - City:DESLOGE
Mailing Address - State:MO
Mailing Address - Zip Code:63601-3132
Mailing Address - Country:US
Mailing Address - Phone:573-247-2532
Mailing Address - Fax:
Practice Address - Street 1:309 GARRETT ST
Practice Address - Street 2:
Practice Address - City:FREDERICKTOWN
Practice Address - State:MO
Practice Address - Zip Code:63645-1084
Practice Address - Country:US
Practice Address - Phone:573-783-4104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020028372101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional