Provider Demographics
NPI:1346227782
Name:HANUS, LAWRENCE JAMES (MA LP)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:JAMES
Last Name:HANUS
Suffix:
Gender:M
Credentials:MA LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 4TH ST NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-3142
Mailing Address - Country:US
Mailing Address - Phone:218-444-5771
Mailing Address - Fax:218-444-5985
Practice Address - Street 1:403 4TH ST NW
Practice Address - Street 2:SUITE 200
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-3142
Practice Address - Country:US
Practice Address - Phone:218-444-5771
Practice Address - Fax:218-444-5985
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP3145103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist