Healthcare Provider Details

I. General information

NPI: 1619306263
Provider Name (Legal Business Name): CHERYL HANSEN LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 MESENA DR APT 202
LYNCHBURG VA
24502-7346
US

IV. Provider business mailing address

97 MESENA DR APT 202
LYNCHBURG VA
24502-7346
US

V. Phone/Fax

Practice location:
  • Phone: 919-578-3297
  • Fax:
Mailing address:
  • Phone: 919-578-3297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701015529
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10246
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: