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General NPI Number Information
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NPI Number | 1578455028
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Entity Type | Individual
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Provider Name | CODY J HANSEN LMSW
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Gender | Male
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Dates
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Enumeration Date | 07/18/2025
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 927 N 71 BUSINESS HWY
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City | ANDERSON
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State | MO
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Zip | 64831-9753
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Country | US
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Telephone | 417-355-9401
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Fax | 417-845-8314
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Provider Business Mailing Address
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Address Line | 6 FAYE LN
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City | BELLA VISTA
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State | AR
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Zip | 72714-4028
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Country | US
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Telephone | 479-321-0160
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 2025028929
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License Number State | MO
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