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NPI 1023337730

NPI 1023337730 : LEAH HANSON LPC : DE QUEEN, AR

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General NPI Number Information
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    NPI Number           |    1023337730
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    Entity Type          |    Individual 
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    Provider Name        |    LEAH HANSON LPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/19/2010
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    Last Update Date     |    04/25/2023
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Provider Practice Location Address
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    Address Line         |    304 W COLLIN RAYE DR STE 103A 
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    City                 |    DE QUEEN
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    State                |    AR
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    Zip                  |    71832-2000
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    Country              |    US
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    Telephone            |    870-330-4460
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    Fax                  |    870-330-4460
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Provider Business Mailing Address
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    Address Line         |    1015 E 35TH ST 
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    City                 |    TEXARKANA
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    State                |    AR
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    Zip                  |    71854-2745
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    Country              |    US
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    Telephone            |    870-330-4460
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    Fax                  |    870-330-4460
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    10-10AE-PL
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    License Number State |    AR
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Taxonomy #2
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    A1107064
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    License Number State |    AR
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Taxonomy #3
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    Taxonomy Code        |    171M00000X
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    Taxonomy Name        |    Case Manager/Care Coordinator
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    License Number       |    
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    License Number State |    
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Taxonomy #4
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    P1503013
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    License Number State |    AR
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