Healthcare Provider Details

I. General information

NPI: 1811821903
Provider Name (Legal Business Name): SAMANTHA HANSON LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9610 W 124TH TER
OVERLAND PARK KS
66213-1834
US

IV. Provider business mailing address

9610 W 124TH TER
OVERLAND PARK KS
66213-1834
US

V. Phone/Fax

Practice location:
  • Phone: 913-787-6377
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number04072
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: