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General NPI Number Information
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NPI Number | 1215623525
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Entity Type | Individual
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Provider Name | ERIC MARTYN HANSEN LPC: 0019254
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Gender | Male
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Dates
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Enumeration Date | 04/11/2023
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 6232 N 7TH ST STE 101
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City | PHOENIX
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State | AZ
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Zip | 85014-1850
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Country | US
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Telephone | 602-694-6313
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Fax |
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Provider Business Mailing Address
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Address Line | 1196 N GRANT ST
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City | DENVER
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State | CO
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Zip | 80203-2377
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Country | US
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Telephone | 720-261-3990
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0019254
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License Number State | CO
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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 | 24355
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License Number State | AZ
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