Provider Demographics
NPI:1205196490
Name:HANSON, AMANDA (PSYD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 ATHENS WAY STE 104
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1351
Mailing Address - Country:US
Mailing Address - Phone:615-320-1155
Mailing Address - Fax:615-320-1177
Practice Address - Street 1:220 ATHENS WAY STE 320
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1311
Practice Address - Country:US
Practice Address - Phone:615-320-1155
Practice Address - Fax:615-320-1177
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TN3557103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health