Provider Demographics
NPI:1487963260
Name:HANES, WILLIAM H (CADC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:HANES
Suffix:
Gender:M
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20728 DUPONT BLVD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-3199
Mailing Address - Country:US
Mailing Address - Phone:302-854-0172
Mailing Address - Fax:302-854-0176
Practice Address - Street 1:20728 DUPONT BLVD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-3199
Practice Address - Country:US
Practice Address - Phone:302-854-0172
Practice Address - Fax:302-854-0176
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE353101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)