Provider Demographics
NPI:1659851160
Name:HANSON, JAMES GERHARD (PHD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GERHARD
Last Name:HANSON
Suffix:
Gender:M
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 NE KEYSTONE CT
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-4556
Mailing Address - Country:US
Mailing Address - Phone:515-330-6008
Mailing Address - Fax:
Practice Address - Street 1:1101 GRANDVIEW AVE OFC 12
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-1526
Practice Address - Country:US
Practice Address - Phone:515-330-6008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2021-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA083586101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health