Provider Demographics
NPI:1659497949
Name:HANSEL, STEVE
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:HANSEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 CRANES ROOST CT
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-3650
Mailing Address - Country:US
Mailing Address - Phone:270-765-2605
Mailing Address - Fax:270-234-8572
Practice Address - Street 1:1311 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2621
Practice Address - Country:US
Practice Address - Phone:270-765-2605
Practice Address - Fax:270-234-8572
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2007-44103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000349178OtherANTHEM
KY30605018Medicaid
KY30605018Medicaid
KY0690954Medicare PIN
KY000000349178OtherANTHEM
KY00206008Medicare PIN
KY00205008Medicare PIN
KY00207008Medicare PIN
KY00201010Medicare PIN
KY00200010Medicare PIN
KY0762254Medicare PIN
KY0763550Medicare PIN
KY00199010Medicare PIN