Healthcare Provider Details

I. General information

NPI: 1023024148
Provider Name (Legal Business Name): SUSAN RIGGS HANSEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 01/22/2020
Certification Date: 01/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 NORTH FRANKLIN STREET SUITE 100
DOYLESTOWN PA
18901-3536
US

IV. Provider business mailing address

16 NORTH FRANKLIN STREET SUITE 100
DOYLESTOWN PA
18901-3536
US

V. Phone/Fax

Practice location:
  • Phone: 214-723-7005
  • Fax: 215-453-5181
Mailing address:
  • Phone: 214-723-7005
  • Fax: 215-453-5181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW013949
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier159262000
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerMAGELLAN BEHAVIORAL HEALT
# 2
Identifier01965054
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: