Provider Demographics
NPI:1073709820
Name:HANSLER, GENEVIEVE R (MSW, LCSW, LCAS)
Entity Type:Individual
Prefix:MRS
First Name:GENEVIEVE
Middle Name:R
Last Name:HANSLER
Suffix:
Gender:F
Credentials:MSW, LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 MILITARY CUTOFF ROAD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-4086
Mailing Address - Country:US
Mailing Address - Phone:910-256-3784
Mailing Address - Fax:910-256-3787
Practice Address - Street 1:1133 MILITARY CUTOFF ROAD
Practice Address - Street 2:SUITE 210
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-4086
Practice Address - Country:US
Practice Address - Phone:910-256-3784
Practice Address - Fax:910-256-3787
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-14
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC005790101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2853609Medicare UPIN
NC6106785Medicaid