Provider Demographics
NPI:1487930012
Name:TUTTLE, HANNAH (LPC, LCAS, CCS, MAC)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:TUTTLE
Suffix:
Gender:F
Credentials:LPC, LCAS, CCS, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9820 NORTHCROSS CENTER CT STE 125
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-7356
Mailing Address - Country:US
Mailing Address - Phone:980-439-9000
Mailing Address - Fax:704-970-0302
Practice Address - Street 1:9820 NORTHCROSS CENTER CT STE 125
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-7356
Practice Address - Country:US
Practice Address - Phone:980-439-9000
Practice Address - Fax:704-970-0302
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2637101YA0400X
NC13263101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1487930012Medicaid