Provider Demographics
NPI:1518450170
Name:HANSEN, LEANNA RAE (LCSW)
Entity Type:Individual
Prefix:
First Name:LEANNA
Middle Name:RAE
Last Name:HANSEN
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 1:1874 W 1650 S
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-6865
Mailing Address - Country:US
Mailing Address - Phone:801-560-8309
Mailing Address - Fax:
Practice Address - Street 1:13073 S WHEATFIELD WAY
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9253
Practice Address - Country:US
Practice Address - Phone:801-907-5622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-08
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical