Provider Demographics
NPI:1205274875
Name:HANSEN, SARAH ELIZABETH (MS, LPC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:780 COMMERCIAL ST SE STE 201
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3463
Mailing Address - Country:US
Mailing Address - Phone:971-373-4533
Mailing Address - Fax:
Practice Address - Street 1:780 COMMERCIAL ST SE STE 305
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3455
Practice Address - Country:US
Practice Address - Phone:971-373-4533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR5375101YM0800X, 106H00000X
171M00000X
ORC6871101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty