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General NPI Number Information
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NPI Number | 1700330875
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Entity Type | Individual
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Provider Name | MARIKA VADEN HANSON LPC, CSSP
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Gender | Female
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Dates
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Enumeration Date | 08/06/2016
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Last Update Date | 12/27/2025
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Provider Practice Location Address
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Address Line | 1601 SALMON CREEK LN STE 2
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City | JUNEAU
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State | AK
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Zip | 99801-7867
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Country | US
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Telephone | 907-738-5747
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 240446
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City | DOUGLAS
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State | AK
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Zip | 99824-0446
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Country | US
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Telephone | 907-738-5747
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | CSSP-14
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License Number State | WY
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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 | 2461274
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 228884
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License Number State | AK
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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 | LPC-2292
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License Number State | WY
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