Provider Demographics
NPI:1780229013
Name:HANSEN, SHANNON (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 620361
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80162-0361
Mailing Address - Country:US
Mailing Address - Phone:970-400-7337
Mailing Address - Fax:
Practice Address - Street 1:7950 S LINCOLN ST STE 111A
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2713
Practice Address - Country:US
Practice Address - Phone:970-400-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-11
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT.0002229106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist