Provider Demographics
NPI:1609329531
Name:HANSEN, LYNDSEY G (MSS)
Entity Type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:G
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 SWALLOW RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-1974
Mailing Address - Country:US
Mailing Address - Phone:973-986-3270
Mailing Address - Fax:
Practice Address - Street 1:882 JACKSONVILLE RD STE 205
Practice Address - Street 2:
Practice Address - City:IVYLAND
Practice Address - State:PA
Practice Address - Zip Code:18974-4807
Practice Address - Country:US
Practice Address - Phone:215-355-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW020340104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker