Provider Demographics
NPI:1942941927
Name:HANSON, AMY (MA)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 GOVERNORS GRANT BLVD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7524
Mailing Address - Country:US
Mailing Address - Phone:803-920-4647
Mailing Address - Fax:
Practice Address - Street 1:426 S LAKE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-3414
Practice Address - Country:US
Practice Address - Phone:803-814-5559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health