Provider Demographics
NPI:1003816661
Name:HANSEN, KAREN E (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:E
Last Name:HANSEN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19625 ISLANDER ST
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1020
Mailing Address - Country:US
Mailing Address - Phone:301-775-3132
Mailing Address - Fax:301-896-6505
Practice Address - Street 1:19625 ISLANDER ST
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1020
Practice Address - Country:US
Practice Address - Phone:301-775-3132
Practice Address - Fax:301-896-6505
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10754104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF490-001OtherBC/BS
MD6999565Medicaid
MD490781Medicare ID - Type Unspecified