Provider Demographics
NPI:1003353343
Name:PAULSEN, HANS PETER (LPC, CSAC)
Entity Type:Individual
Prefix:
First Name:HANS
Middle Name:PETER
Last Name:PAULSEN
Suffix:
Gender:M
Credentials:LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 BUSH RIVER DR
Mailing Address - Street 2:PO DRAWER 248
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-3179
Mailing Address - Country:US
Mailing Address - Phone:434-392-3187
Mailing Address - Fax:434-392-5789
Practice Address - Street 1:214 BUSH RIVER DR
Practice Address - Street 2:PO DRAWER 248
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-3179
Practice Address - Country:US
Practice Address - Phone:434-392-3187
Practice Address - Fax:434-392-5789
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710001282101YA0400X
VA0701006954101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)