Provider Demographics
NPI:1427385863
Name:HANSON, CATHERINE (RN, LMHC, CAGS)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:RN, LMHC, CAGS
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:KETNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:1544 FRENCHTOWN RD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1311
Mailing Address - Country:US
Mailing Address - Phone:401-741-0853
Mailing Address - Fax:
Practice Address - Street 1:24 SALT POND RD
Practice Address - Street 2:B4
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-4314
Practice Address - Country:US
Practice Address - Phone:401-783-1310
Practice Address - Fax:401-783-7596
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2016-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN32761163W00000X
RIMHC00663101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICK42287Medicaid