Organization
AUTHENTICALLY DIVERGENT COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN HANNUM (OWNER)
(937) 307-2823
Entity
Organization
Contact information
Practice address
6478 FIRESIDE DR, CENTERVILLE, OH 45459-2007
(937) 307-2823
Mailing address
6478 FIRESIDE DR, CENTERVILLE, OH 45459-2007
(937) 883-6961
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0167235
—
OH
Enumeration date
07/07/2025
Last updated
02/24/2026
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