Healthcare Provider Details

I. General information

NPI: 1508017203
Provider Name (Legal Business Name): SYNTHIA DAWN HANSEN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2008
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 CLARK SUMMIT DR
BLUFFTON SC
29910-4205
US

IV. Provider business mailing address

19 ANTHEM DR
BLUFFTON SC
29910-4576
US

V. Phone/Fax

Practice location:
  • Phone: 843-473-8213
  • Fax: 843-582-0261
Mailing address:
  • Phone: 843-473-8213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9300
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.007359
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC015156
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: