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NPI Code Detail

MEDICARE: ELLE HANSEN, LLC

MEDICARE: ELLE HANSEN, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1154291847
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELLE HANSEN, LLC
Provider Business Mailing Address
First Line : PO BOX 104
Second Line :
City : FARMINGTON
State : ME
Zip : 04938-0104
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 131 MEADOW LN
Second Line :
City : FARMINGTON
State : ME
Zip : 04938-6107
Country : US
Telephone Number : 802-300-4469
Fax Number :
Authorized Official
Title or Position : OWNER / BEHAVIORAL HEALTH CLINICIAN
Name : DANIELLE HANSEN
Credential : LCSW
Telephone Number : 802-300-4469
Provider Enumeration Date : 11/07/2025
Last Update Date : 11/07/2025

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