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NPI Code Detail

MEDICARE: RICHARD HANSON

MEDICARE: RICHARD HANSON
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1194083501
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD HANSON
Provider Business Mailing Address
First Line : 41 W 5TH AVE
Second Line :
City : WILLIAMSON
State : WV
Zip : 25661-3201
Country : US
Telephone Number : 304-235-3390
Fax Number : 304-235-3391
Provider Business Practice Location Address
First Line : 41 W 5TH AVE
Second Line :
City : WILLIAMSON
State : WV
Zip : 25661-3201
Country : US
Telephone Number : 304-235-3390
Fax Number : 304-235-3391
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2012
Last Update Date : 02/23/2017

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