Provider Demographics
NPI:1356813166
Name:HANSEN, KAREN LYNN (LCPC, LADC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LYNN
Last Name:HANSEN
Suffix:
Gender:F
Credentials:LCPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 153
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04843-0153
Mailing Address - Country:US
Mailing Address - Phone:207-466-1115
Mailing Address - Fax:
Practice Address - Street 1:62 BAY VIEW ST # 22
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-2252
Practice Address - Country:US
Practice Address - Phone:207-370-5006
Practice Address - Fax:877-470-9719
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-19
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC7446101YA0400X, 101YA0400X
MECC5980101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA13532OtherLMHC
MECC5980OtherLCPC
MELC7446OtherLADC
SCTLC228PCOtherLCPC