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General NPI Number Information
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NPI Number | 1972779296
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Entity Type | Individual
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Provider Name | KURT MICHAEL HANUS M.A.
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Gender | Male
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 04/24/2015
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Provider Practice Location Address
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Address Line | 115 E FIRST ST #1S
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City | HINSDALE
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State | IL
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Zip | 60521-4254
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Country | US
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Telephone | 630-484-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 9599 US HIGHWAY 12
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City | NEW BUFFALO
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State | MI
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Zip | 49117-9269
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Country | US
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Telephone | 312-409-4819
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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 | 180005412
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401009179
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License Number State | MI
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