Provider Demographics
NPI:1588856389
Name:HANSEN, KANDIE M (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:KANDIE
Middle Name:M
Last Name:HANSEN
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 WATERFORD CIR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2145
Mailing Address - Country:US
Mailing Address - Phone:615-497-5338
Mailing Address - Fax:
Practice Address - Street 1:3601 WATERFORD CIR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2145
Practice Address - Country:US
Practice Address - Phone:615-497-5338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2810101YM0800X, 101YP2500X
KY172547101YP2500X
GA011994101YP2500X
TX85685101YP2500X
MO202219957101YP2500X
CT7092101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health