Healthcare Provider Details

I. General information

NPI: 1427469931
Provider Name (Legal Business Name): HANSON ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 05/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 HOLCOMB BRIDGE RD STE 230 STE 230, SPALDING WOODS
NORCROSS GA
30092-5240
US

IV. Provider business mailing address

4849 MILL BROOK DR
ATLANTA GA
30338-4905
US

V. Phone/Fax

Practice location:
  • Phone: 404-846-7603
  • Fax:
Mailing address:
  • Phone: 770-329-4663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC00002476
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: PAULA HANSON-KAHN
Title or Position: CLINICAL DIRECTOR
Credential:
Phone: 770-329-4663