MEDICARE: CHRISTY LEIGH HANSEN LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6277	KS

General Provider Information

NPI Number	:	1538750682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTY LEIGH HANSEN LMSW

Provider Business Mailing Address
First Line	:	9001 STATE LINE ROAD #300
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64114-3232
Country	:	US
Telephone Number	:	816-363-2600
Fax Number	:	816-523-0068

Provider Business Practice Location Address
First Line	:	8012 STATE LINE RD
Second Line	:
City	:	PRAIRIE VILLAGE
State	:	KS
Zip	:	66208-3722
Country	:	US
Telephone Number	:	913-341-0318
Fax Number	:	913-341-0319

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2021
Last Update Date	:	09/02/2022

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