Provider Demographics
NPI:1013051481
Name:HANSEL, JEANNE MARIE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:MARIE
Last Name:HANSEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2185 WOOD HOLLOW WAY
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-1217
Mailing Address - Country:US
Mailing Address - Phone:801-915-0329
Mailing Address - Fax:801-444-3558
Practice Address - Street 1:466 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015-3222
Practice Address - Country:US
Practice Address - Phone:801-915-0329
Practice Address - Fax:801-915-0329
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT137460-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical