Provider Demographics
NPI:1851671853
Name:HANSEN, LINDSAY ANN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:ANN
Last Name:HANSEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:LINDSAY
Other - Middle Name:ANN
Other - Last Name:BURT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFTA, MA
Mailing Address - Street 1:1908 NW 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-6523
Mailing Address - Country:US
Mailing Address - Phone:253-279-0032
Mailing Address - Fax:253-620-5831
Practice Address - Street 1:105 W MAIN STE #211
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-6823
Practice Address - Country:US
Practice Address - Phone:360-836-0971
Practice Address - Fax:360-699-1900
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-22
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG60463231106H00000X
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2164476Medicaid