Provider Demographics
NPI:1093996027
Name:HANSON, LEWIS CHARLES (MS)
Entity Type:Individual
Prefix:MR
First Name:LEWIS
Middle Name:CHARLES
Last Name:HANSON
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3126 APPLE VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-3402
Mailing Address - Country:US
Mailing Address - Phone:256-835-3042
Mailing Address - Fax:
Practice Address - Street 1:3126 APPLE VALLEY LN
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-3402
Practice Address - Country:US
Practice Address - Phone:256-835-3042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health