Provider Demographics
NPI:1578025763
Name:HANSEN, MICHELE (LPC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:HANSEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-2353
Mailing Address - Country:US
Mailing Address - Phone:800-423-1342
Mailing Address - Fax:785-628-3113
Practice Address - Street 1:4155 E HARRY ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-3725
Practice Address - Country:US
Practice Address - Phone:800-423-1342
Practice Address - Fax:785-628-3113
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3134101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health