Provider Demographics
NPI:1356403869
Name:HANSON, SCOTT ALFRED (LISW)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ALFRED
Last Name:HANSON
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 393
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:IA
Mailing Address - Zip Code:50211-0393
Mailing Address - Country:US
Mailing Address - Phone:515-419-7494
Mailing Address - Fax:
Practice Address - Street 1:1329 SUNSET DR
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:IA
Practice Address - Zip Code:50211-1343
Practice Address - Country:US
Practice Address - Phone:515-419-7494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA011341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical