Provider Demographics
NPI:1376882852
Name:HANSEN, JOAN KRISTI (PLMHP)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:KRISTI
Last Name:HANSEN
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21898 BOBWHITE AVE
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:NE
Mailing Address - Zip Code:68028-5943
Mailing Address - Country:US
Mailing Address - Phone:402-332-3401
Mailing Address - Fax:
Practice Address - Street 1:11620 ARBOR ST STE 203
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2972
Practice Address - Country:US
Practice Address - Phone:402-504-4924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9883101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health