| Doctor Name: | MITCHELL B. HANNAFIUS |
| NPI Number: | 1689872913 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMSW |
| License Number: | 33004521A |
| Business Practice Address: | 261 M 62 Cassopolis, MI - 490311034 |
| Business Phone Number: | 2694453874 |
| Business Fax Number: | 2694452076 |
| Mailing Address: | 2415 Burton Rd, NILES |
| State: | MI |
| Postal Code: | 491209203 |
| Phone Number: | 2695912360 |
| Fax Number: | |
| NPI Enumeration Date: | 07/09/2007 |
| NPI Last Update Date: | 11/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 33004521A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |