Provider Demographics
NPI:1457328643
Name:WILL, ELIZABETH HANSON (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:HANSON
Last Name:WILL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5605 WASHINGTON AVE STE 7D
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53406-4056
Mailing Address - Country:US
Mailing Address - Phone:262-260-9383
Mailing Address - Fax:
Practice Address - Street 1:5605 WASHINGTON AVE STE 7D
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53406-4056
Practice Address - Country:US
Practice Address - Phone:262-260-9383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7096-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI46987600Medicaid