Provider Demographics
NPI:1316373624
Name:HANSON, CHAD N (LPC)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:N
Last Name:HANSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-2371
Mailing Address - Country:US
Mailing Address - Phone:208-505-4314
Mailing Address - Fax:
Practice Address - Street 1:4 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-2371
Practice Address - Country:US
Practice Address - Phone:208-505-4314
Practice Address - Fax:208-475-4460
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-5265101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor