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General NPI Number Information
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NPI Number | 1104930940
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Entity Type | Individual
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Provider Name | CHRISTINE M HANSEN MS LCSW SAC LPC
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Gender | Female
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 333 N GREEN BAY RD
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City | NEENAH
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State | WI
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Zip | 54956-1954
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Country | US
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Telephone | 920-720-2300
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Fax | 920-720-3719
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Provider Business Mailing Address
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Address Line | 1095 MIDWAY RD
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City | MENASHA
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State | WI
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Zip | 54952-1115
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Country | US
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Telephone | 920-720-2300
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Fax | 920-720-3719
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 12499
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 915
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 1805-123
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License Number State | WI
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