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General NPI Number Information
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NPI Number | 1881434231
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Entity Type | Organization
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Legal Business Name | SIRI E. HANSEN, LCPC
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Dates
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Enumeration Date | 05/31/2024
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 629 CATINO CT
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City | ROSELLE
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State | IL
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Zip | 60172-3014
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Country | US
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Telephone | 630-315-5118
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Fax |
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Provider Business Mailing Address
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Address Line | 629 CATINO CT
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City | ROSELLE
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State | IL
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Zip | 60172-3014
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Country | US
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Telephone | 630-315-5118
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Fax |
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Authorized Official
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Title or Position | SIRI E. HANSEN, LCPC OWNER
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Name | MS. SIRI E. HANSEN
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Credential | LCPC
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Telephone | 630-351-5118
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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