Healthcare Provider Details

I. General information

NPI: 1932628211
Provider Name (Legal Business Name): HANSEN COUNSELING LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2017
Last Update Date: 11/08/2021
Certification Date: 11/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19855 4TH ST STE 106
BEND OR
97703-7814
US

IV. Provider business mailing address

19855 4TH ST STE 106
BEND OR
97703-7814
US

V. Phone/Fax

Practice location:
  • Phone: 541-388-8457
  • Fax:
Mailing address:
  • Phone: 541-388-8457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. RANDI HILL HANSEN
Title or Position: OWNER
Credential: MSW, LCSW
Phone: 541-388-8457