George Ivar Hannibal, LCSW, CADCI - Medicare in Portland, OR

George Ivar Hannibal, LCSW, CADCI is a medicare enrolled "Counselor - Addiction (substance Use Disorder)" provider in Portland, Oregon. His current practice location is 1419 Ne 69th Ave, Portland, Oregon. You can reach out to his office (for appointments etc.) via phone at (503) 254-1545.

George Ivar Hannibal is licensed to practice in Oregon (license number 01-11-26) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1003866708.

Contact Information

George Ivar Hannibal, LCSW, CADCI
1419 Ne 69th Ave,
Portland, OR 97213-5301
(503) 254-1545
(503) 525-2846



Healthcare Provider's Profile

Full NameGeorge Ivar Hannibal
GenderMale
SpecialityCounselor - Addiction (substance Use Disorder)
Location1419 Ne 69th Ave, Portland, Oregon
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1003866708
  • Provider Enumeration Date: 05/11/2006
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 8921108531
  • Enrollment ID: I20070711001001

Medical Identifiers

Medical identifiers for George Ivar Hannibal such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003866708NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical L0525 (Oregon)Primary
101YA0400XCounselor - Addiction (substance Use Disorder) 01-11-26 (Oregon)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. George Ivar Hannibal is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
George Ivar Hannibal, LCSW, CADCI
1419 Ne 69th Ave,
Portland, OR 97213-5301

Ph: (503) 254-1545
George Ivar Hannibal, LCSW, CADCI
1419 Ne 69th Ave,
Portland, OR 97213-5301

Ph: (503) 254-1545

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