Healthcare Provider Details

I. General information

NPI: 1538281381
Provider Name (Legal Business Name): CATHERINE HANSEN PH.D., M.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 10/26/2023
Certification Date: 10/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 KEYSER AVE STE B
NATCHITOCHES LA
71457-6037
US

IV. Provider business mailing address

740 KEYSER AVE NATCHITOCHES VA COMM. BASED OUTPATIENT CLINIC, STE. B
NATCHITOCHES LA
71457-6037
US

V. Phone/Fax

Practice location:
  • Phone: 318-357-3311
  • Fax:
Mailing address:
  • Phone: 318-357-3311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number714
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number714MP
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number308876
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number714MP
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License NumberMP.000714
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: