Provider Demographics
NPI:1770877318
Name:HANSEN-COHEN ASSOCIATES IN PSYCHOLOGY, INC
Entity type:Organization
Organization Name:HANSEN-COHEN ASSOCIATES IN PSYCHOLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:239-274-7792
Mailing Address - Street 1:4301 VERONICA S SHOEMAKER BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-2216
Mailing Address - Country:US
Mailing Address - Phone:239-274-7792
Mailing Address - Fax:239-247-5344
Practice Address - Street 1:4301 VERONICA S SHOEMAKER BLVD STE B
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33916-2216
Practice Address - Country:US
Practice Address - Phone:239-274-7792
Practice Address - Fax:239-247-5344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7935103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPY 7935OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH