Provider Demographics
NPI:1942372172
Name:HANSON, LUANN K (MS LICSW)
Entity Type:Individual
Prefix:
First Name:LUANN
Middle Name:K
Last Name:HANSON
Suffix:
Gender:F
Credentials:MS LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1523 HIGHWAY 13 E
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-2917
Mailing Address - Country:US
Mailing Address - Phone:952-894-4828
Mailing Address - Fax:507-387-7368
Practice Address - Street 1:1523 HIGHWAY 13 E
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-2917
Practice Address - Country:US
Practice Address - Phone:952-894-4828
Practice Address - Fax:507-387-7368
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN160741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical