Healthcare Provider Details

I. General information

NPI: 1629649611
Provider Name (Legal Business Name): LAUREN HANSEN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 08/07/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY STREET POTTER 1
PROVIDENCE RI
02903
US

IV. Provider business mailing address

940 QUAKER LN APT 1623
EAST GREENWICH RI
02818-5044
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-2128
  • Fax:
Mailing address:
  • Phone: 401-207-8388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW03997
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCSW02412
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: