Provider Demographics
NPI:1659650117
Name:HANKS, EPHRAIM K (LCSW, LMFT)
Entity Type:Individual
Prefix:
First Name:EPHRAIM
Middle Name:K
Last Name:HANKS
Suffix:
Gender:M
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 W 375 S
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:UT
Mailing Address - Zip Code:84737-3250
Mailing Address - Country:US
Mailing Address - Phone:435-703-0218
Mailing Address - Fax:
Practice Address - Street 1:677 W 375 S
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:UT
Practice Address - Zip Code:84737-3250
Practice Address - Country:US
Practice Address - Phone:435-703-0218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6234926-3902106H00000X
UT6234926-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist