Provider Demographics
NPI:1447765367
Name:BROWN-HANSON, MELANIE (LMSW)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:BROWN-HANSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 W SCHILLING RD
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-8131
Mailing Address - Country:US
Mailing Address - Phone:785-827-9383
Mailing Address - Fax:785-823-2015
Practice Address - Street 1:1502 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:CONCORDIA
Practice Address - State:KS
Practice Address - Zip Code:66901
Practice Address - Country:US
Practice Address - Phone:785-243-1977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-14
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMSW101171041C0700X
KS104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201146980AMedicaid