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General NPI Number Information
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NPI Number | 1598678377
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Entity Type | Individual
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Provider Name | RILEY MICHAEL HANSEN
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Gender | Male
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | 4923 LINCOLN WAY
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City | AMES
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State | IA
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Zip | 50014-3616
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Country | US
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Telephone | 800-531-4236
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Fax | 319-483-6661
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Provider Business Mailing Address
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Address Line | 1417 MAYFIELD DR UNIT 308
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City | AMES
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State | IA
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Zip | 50014-5571
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Country | US
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Telephone | 712-260-9600
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 139978
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License Number State | IA
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