Provider Demographics
NPI:1093787368
Name:HANSON ASSOCIATES LLC
Entity Type:Organization
Organization Name:HANSON ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:763-533-5339
Mailing Address - Street 1:7200 HEMLOCK LN N SUITE 108
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-5576
Mailing Address - Country:US
Mailing Address - Phone:763-533-5339
Mailing Address - Fax:763-390-0863
Practice Address - Street 1:7200 HEMLOCK LN N SUITE 108
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-5576
Practice Address - Country:US
Practice Address - Phone:763-533-5339
Practice Address - Fax:763-390-0862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN208624700Medicaid
MN337M7HAOtherBCBS MN PROVIDER ID
MN107643OtherHEALTH PARTNER ID NUMBER