Individual provider · Type 1 NPI
George Ivar Hannibal, LCSW, CADCI
Addiction (Substance Use Disorder) Counselor · Portland, OR
NPI number
1003866708
Active
Practice location
1419 NE 69th Ave
Portland, OR 97213-5301
Fax (503) 525-2846
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker | 1041C0700X | L0525 (OR) |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 01-11-26 (OR) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
3 other providers at this address
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About NPI 1003866708
George Ivar Hannibal, LCSW, CADCI's National Provider Identifier is 1003866708, issued on May 11, 2006. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Portland, OR. The record was last updated on Sep 11, 2025.