Provider Demographics
NPI:1508389792
Name:HANSEN, RYAN CHRISTOPHER (LPC, ATR-P)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:CHRISTOPHER
Last Name:HANSEN
Suffix:
Gender:M
Credentials:LPC, ATR-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-2135
Mailing Address - Country:US
Mailing Address - Phone:630-823-8323
Mailing Address - Fax:630-855-3697
Practice Address - Street 1:900 S PARK BLVD
Practice Address - Street 2:
Practice Address - City:STREAMWOOD
Practice Address - State:IL
Practice Address - Zip Code:60107-2135
Practice Address - Country:US
Practice Address - Phone:630-823-8323
Practice Address - Fax:630-855-3697
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.012522101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional