Provider Demographics
NPI:1053831016
Name:HANSON, EMILY RANA (LCDC, LPC-INTERN)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:RANA
Last Name:HANSON
Suffix:
Gender:F
Credentials:LCDC, LPC-INTERN
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:RANA
Other - Last Name:STARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6315 TEN MILE BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76135-1339
Mailing Address - Country:US
Mailing Address - Phone:817-800-0418
Mailing Address - Fax:
Practice Address - Street 1:1801 N RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76111-2732
Practice Address - Country:US
Practice Address - Phone:817-601-8775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13824101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)