1114353570 NPI number — PL HANSEN COUNSELING INC

Table of content: (NPI 1114353570)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114353570 NPI number — PL HANSEN COUNSELING INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PL HANSEN COUNSELING INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114353570
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/17/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8184 S HIGHLAND DR
Provider Second Line Business Mailing Address:
SUITE C-8
Provider Business Mailing Address City Name:
SANDY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84093-6477
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-944-1666
Provider Business Mailing Address Fax Number:
801-944-1698

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8184 S HIGHLAND DR
Provider Second Line Business Practice Location Address:
SUITE C-8
Provider Business Practice Location Address City Name:
SANDY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84093-6477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-944-1666
Provider Business Practice Location Address Fax Number:
801-944-1698
Provider Enumeration Date:
09/17/2013

Additional Information

Authorized Official

Authorized Official Last Name:
HANSEN
Authorized Official First Name:
PHILLIP
Authorized Official Middle Name:
LOUIS
Authorized Official Title or Position:
CLINICAL SOCIAL WORKER
Authorized Official Telephone Number:
801-944-1666

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X , with the licence number:  139806-3501 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 264612 . This is a "MHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 35627 . This is a "RELIANT BEHAVIORAL HEALTH" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 76387C , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 11416122 . This is a "AETNA" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: IP308254 . This is a "MAGELLAN" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com