Provider Demographics
NPI:1821463738
Name:HANKINS, STANLEY (MA, BCBA)
Entity Type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:
Last Name:HANKINS
Suffix:
Gender:M
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 HIAWATHA TRL
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-1006
Mailing Address - Country:US
Mailing Address - Phone:859-317-0630
Mailing Address - Fax:
Practice Address - Street 1:508 HIAWATHA TRL
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-1006
Practice Address - Country:US
Practice Address - Phone:859-317-0630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY101547103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100382830Medicaid